1. Annear DJ, Vandeweyer G, Sanchis-Juan A, Raymond FL, Kooy RF. Non-Mendelian inheritance patterns and extreme deviation rates of CGG repeats in autism. Genome research. 2022.

As expansions of CGG short tandem repeats (STR) are established as the genetic etiology of many neurodevelopmental disorders, we aimed to elucidate the inheritance patterns and role of CGG STRs in autism-spectrum disorder (ASD). By genotyping 6,063 CGG STR loci in a large cohort of trios and quads with an ASD-affected proband we determined an unprecedented rate of CGG repeat length deviation across a single generation. While the concept of repeat length being linked to deviation rate was solidified, we demonstrate how shorter STRs display greater degrees of size variation. We observed that CGG STRs did not segregate by Mendelian principles, with a bias against longer repeats, which appeared to magnify as repeat length increased. Through logistic regression, we identified 19 genes that displayed significantly higher rates and degrees of CGG STR expansion within the ASD-affected probands (p < 1 x 10-5). This study not only highlights novel repeat expansions that may play a role in ASD but also reinforces the hypothesis that CGG STRs are specifically linked to human cognition.

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2. Bartl-Pokorny KD, Pokorny FB, Garrido D, Schuller BW, Zhang D, Marschik PB. Vocalisation Repertoire at the End of the First Year of Life: An Exploratory Comparison of Rett Syndrome and Typical Development. Journal of developmental and physical disabilities. 2022; 34(6): 1053-69.

Rett syndrome (RTT) is a rare, late detected developmental disorder associated with severe deficits in the speech-language domain. Despite a few reports about atypicalities in the speech-language development of infants and toddlers with RTT, a detailed analysis of the pre-linguistic vocalisation repertoire of infants with RTT is yet missing. Based on home video recordings, we analysed the vocalisations between 9 and 11 months of age of three female infants with typical RTT and compared them to three age-matched typically developing (TD) female controls. The video material of the infants had a total duration of 424 min with 1655 infant vocalisations. For each month, we (1) calculated the infants’ canonical babbling ratios with CBR(UTTER), i.e., the ratio of number of utterances containing canonical syllables to total number of utterances, and (2) classified their pre-linguistic vocalisations in three non-canonical and four canonical vocalisation subtypes. All infants achieved the milestone of canonical babbling at 9 months of age according to their canonical babbling ratios, i.e. CBR(UTTER) ≥ 0.15. We revealed overall lower CBRs(UTTER) and a lower proportion of canonical pre-linguistic vocalisations consisting of well-formed sounds that could serve as parts of target-language words for the RTT group compared to the TD group. Further studies with more data from individuals with RTT are needed to study the atypicalities in the pre-linguistic vocalisation repertoire which may portend the later deficits in spoken language that are characteristic features of RTT.

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3. Bettoni R, Addabbo M, Ghidina C, Pezzana C, Vagni D, Turati C, Bulf H. Learning and generalization of repetition-based rules in autism. Psychological research. 2022.

Rule Learning (RL) allows us to extract and generalize high-order rules from a sequence of elements. Despite the critical role of RL in the acquisition of linguistic and social abilities, no study has investigated RL processes in Autism Spectrum Disorder (ASD). Here, we investigated RL in high-functioning autistic adolescents with ASD, examining whether their ability to extract and generalize rules from a sequence of visual elements is affected by the social vs. non-social nature of the stimulus and by visual working memory (WM). Using a forced-choice paradigm, ASD adolescents and typically developing (TD) peers were tested for their ability to detect and generalize high-order, repetition-based rules from visual sequences of simple non-social stimuli (shapes), complex non-social stimuli (inverted faces), and social stimuli (upright face). Both ASD and TD adolescents were able to generalize the rule they had learned to new stimuli, and their ability was modulated by the social nature of the stimuli and the complexity of the rule. Moreover, an association between RL and WM was found in the ASD, but not TD group, suggesting that ASD might have used additional or alternative strategies that relied on visual WM resources.

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4. Brandenburg C, Griswold AJ, Van Booven DJ, Kilander MBC, Frei JA, Nestor MW, Dykxhoorn DM, Pericak-Vance MA, Blatt GJ. Transcriptomic analysis of isolated and pooled human postmortem cerebellar Purkinje cells in autism spectrum disorders. Frontiers in genetics. 2022; 13: 944837.

At present, the neuronal mechanisms underlying the diagnosis of autism spectrum disorder (ASD) have not been established. However, studies from human postmortem ASD brains have consistently revealed disruptions in cerebellar circuitry, specifically reductions in Purkinje cell (PC) number and size. Alterations in cerebellar circuitry would have important implications for information processing within the cerebellum and affect a wide range of human motor and non-motor behaviors. Laser capture microdissection was performed to obtain pure PC populations from a cohort of postmortem control and ASD cases and transcriptional profiles were compared. The 427 differentially expressed genes were enriched for gene ontology biological processes related to developmental organization/connectivity, extracellular matrix organization, calcium ion response, immune function and PC signaling alterations. Given the complexity of PCs and their far-ranging roles in response to sensory stimuli and motor function regulation, understanding transcriptional differences in this subset of cerebellar cells in ASD may inform on convergent pathways that impact neuronal function.

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5. Chang YS, Chen LW, Yu T, Lin SH, Kuo PL. Preterm birth and weight-for-gestational age for risks of autism spectrum disorder and intellectual disability: A nationwide population-based cohort study. Journal of the Formosan Medical Association = Taiwan yi zhi. 2022.

PURPOSE: To evaluate gestational age (GA) and small-for-gestational age (SGA) as continuums and gender on the incidences of autism spectrum disorder (ASD) and co-occurring intellectual disability (ID). METHODS: This is a population-based cohort study using the 2004-2008 Taiwan Maternal and Child Health Database. The diagnosis of ASD was determined by International Classification of Diseases, 9th Revision (ICD-9). Generalized estimating equations models were fit to evaluate associations between perinatal variables and ASD. RESULTS: This study included 916,315 individuals. A total of 9474 (1.0%) children were diagnosed with ASD, among whom 1594 (16.8%) had co-occurring ID. Lower GA carried higher odds of ASD with ID (GA < 28 weeks, aOR: 4.26, 95% CI: 2.13, 8.50; GA 28-30 weeks, aOR: 2.80, 95% CI: 1.57, 4.97; GA 31-33 weeks, aOR: 1.63, 95% CI: 1.05, 2.55; GA 34-36 weeks, aOR: 1.39, 95% CI: 1.16, 1.67) and ASD without ID (GA < 28 weeks, aOR:2.05, 95% CI: 1.25, 3.36; GA 28-30 weeks, aOR: 2.02, 95% CI: 1.46, 2.79; GA 31-33 weeks, aOR: 1.42, 95% CI: 1.13, 1.77; GA 34-36 weeks, aOR: 1.18, 95% CI: 1.08, 1.29). Male preterm infants had ASD risks negatively correlated to GA, while ASD risks were significantly increased only among female infants born late preterm. The degree of SGA showed a stepwise increased risk for ASD with and without ID in both male and female infants. CONCLUSION: Lower GA and the degree of SGA are both associated with ASD susceptibility, either with or without co-occurring ID, and remarkably increased the risk of ID.

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6. Chenausky KV, Maffei M, Tager-Flusberg H, Green JR. Review of methods for conducting speech research with minimally verbal individuals with autism spectrum disorder. Augmentative and alternative communication (Baltimore, Md : 1985). 2022: 1-12.

The purpose of this paper was to review best-practice methods of collecting and analyzing speech production data from minimally verbal autistic speakers. Data on speech production data in minimally verbal individuals are valuable for a variety of purposes, including phenotyping, clinical assessment, and treatment monitoring. Both perceptual (« by ear ») and acoustic analyses of speech can reveal subtle improvements as a result of therapy that may not be apparent when correct/incorrect judgments are used. Key considerations for collecting and analyzing speech production data from this population are reviewed. The definition of « minimally verbal » that is chosen will vary depending on the specific hypotheses investigated, as will the stimuli to be collected and the task(s) used to elicit them. Perceptual judgments are ecologically valid but subject to known sources of bias; therefore, training and reliability procedures for perceptual analyses are addressed, including guidelines on how to select vocalizations for inclusion or exclusion. Factors to consider when recording and acoustically analyzing speech are also briefly discussed. In summary, the tasks, stimuli, training methods, analysis type(s), and level of detail that yield the most reliable data to answer the question should be selected. It is possible to obtain rich high-quality data even from speakers with very little speech output. This information is useful not only for research but also for clinical decision-making and progress monitoring.

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7. Fujihira H, Itoi C, Furukawa S, Kato N, Kashino M. Sensitivity to interaural level and time differences in individuals with autism spectrum disorder. Scientific reports. 2022; 12(1): 19142.

Individuals with autism spectrum disorders (ASD) are reported to exhibit degraded performance in sound localization. This study investigated whether the sensitivity to the interaural level differences (ILDs) and interaural time differences (ITDs), major cues for horizontal sound localization, are affected in ASD. Thresholds for discriminating the ILD and ITD were measured for adults with ASD and age- and IQ-matched controls in a lateralization experiment. Results show that the ASD group exhibited higher ILD and ITD thresholds than the control group. Moreover, there was a significant diversity of ITD sensitivity in the ASD group, and it contained a larger proportion of participants with poor ITD sensitivity than the control group. The current study suggests that deficits in relatively low-level processes in the auditory pathway are implicated in degraded performance of sound localization in individuals with ASD. The results are consistent with the structural abnormalities and great variability in the morphology in the brainstem reported by neuroanatomical studies of ASD.

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8. Hassan WM, Al-Dbass A, Al-Ayadhi L, Bhat RS, El-Ansary A. Author Correction: Discriminant analysis and binary logistic regression enable more accurate prediction of autism spectrum disorder than principal component analysis. Scientific reports. 2022; 12(1): 19049.

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9. Hirsch J, Zhang X, Noah JA, Dravida S, Naples A, Tiede M, Wolf JM, McPartland JC. Neural correlates of eye contact and social function in autism spectrum disorder. PloS one. 2022; 17(11): e0265798.

Reluctance to make eye contact during natural interactions is a central diagnostic criterion for autism spectrum disorder (ASD). However, the underlying neural correlates for eye contacts in ASD are unknown, and diagnostic biomarkers are active areas of investigation. Here, neuroimaging, eye-tracking, and pupillometry data were acquired simultaneously using two-person functional near-infrared spectroscopy (fNIRS) during live « in-person » eye-to-eye contact and eye-gaze at a video face for typically-developed (TD) and participants with ASD to identify the neural correlates of live eye-to-eye contact in both groups. Comparisons between ASD and TD showed decreased right dorsal-parietal activity and increased right ventral temporal-parietal activity for ASD during live eye-to-eye contact (p≤0.05, FDR-corrected) and reduced cross-brain coherence consistent with atypical neural systems for live eye contact. Hypoactivity of right dorsal-parietal regions during eye contact in ASD was further associated with gold standard measures of social performance by the correlation of neural responses and individual measures of: ADOS-2, Autism Diagnostic Observation Schedule, 2nd Edition (r = -0.76, -0.92 and -0.77); and SRS-2, Social Responsiveness Scale, Second Edition (r = -0.58). The findings indicate that as categorized social ability decreases, neural responses to real eye-contact in the right dorsal parietal region also decrease consistent with a neural correlate for social characteristics in ASD.

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10. Karavallil Achuthan S, Coburn KL, Beckerson ME, Kana RK. Amplitude of low frequency fluctuations during resting state fMRI in autistic children. Autism research : official journal of the International Society for Autism Research. 2022.

Resting state fMRI (rs-fMRI) provides an excellent platform for examining the amplitude of low frequency fluctuations (ALFF) and fractional amplitude of low frequency fluctuations (fALFF), which are key indices of brain functioning. However, ALFF and fALFF have been used only sporadically to study autism. rs-fMRI data from 69 children (40 autistic, mean age = 8.47 ± 2.20 years; age range: 5.2 to 13.2; and 29 non-autistic, mean age = 9.02 ± 1.97 years; age range 5.9 to 12.9) were obtained from the Autism Brain Imaging Data Exchange (ABIDE II). ALFF and fALFF were measured using CONN connectivity toolbox and SPM12, at whole-brain & network-levels. A two-sampled t-test and a 2 Group (autistic, non-autistic) × 7 Networks ANOVA were conducted to test group differences in ALFF and fALFF. The whole-brain analysis identified significantly reduced ALFF values for autistic participants in left parietal opercular cortex, precuneus, and right insula. At the network level, there was a significant effect of diagnostic group and brain network on ALFF values, and only significant effect of network, not group, on fALFF values. Regression analyses indicated a significant effect of age on ALFF values of certain networks in autistic participants. Such intrinsically different network-level responses in autistic participants may have implications for task-level recruitment and synchronization of brain areas, which may in turn impact optimal cognitive functioning. Moreover, differences in low frequency fluctuations of key networks, such as the DMN and SN, may underlie alterations in brain responses in autism that are frequently reported in the literature.

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11. Kulasinghe K, Whittingham K, Mitchell AE. Emotional availability in the mother-child relationship for families of young children with autism spectrum disorder in Australia: A cross-sectional survey. Research in developmental disabilities. 2022; 131: 104365.

BACKGROUND: In families of children with autism spectrum disorder (ASD) the mother-child relationship can be affected by many factors; however, the impacts of maternal broad autism phenotype (BAP) and attachment styles are unknown. This study investigated predictors of emotional availability in the mother-child relationship in families of children with ASD. METHODS: Mothers (N = 231) of children with ASD living in Australia completed questionnaires assessing emotional availability in the parent-child relationship (mutual attunement, child involvement, affect quality) and mothers’ BAP, mental health, adult attachment style and parenting experiences. Hierarchical multiple regressions and a mediation analysis were conducted. RESULTS: Parent-reported positive parenting experiences was the greatest predictor of mutual attunement, child involvement and affect quality in the parent-child relationship. Maternal stress and anxiety predicted poorer mutual attunement, stress and depressive symptoms predicted less child involvement and anxiety predicted worse affect quality. Negative parenting experiences, maternal anxiety and stress mediated the relationship between BAP and mutual attunement. CONCLUSION: Interventions combining mental health and parenting support for mothers of children with ASD to bolster emotional availability within the mother-child relationship may be warranted.

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12. Li Q, Weiland RF, Konvalinka I, Mansvelder HD, Andersen TS, Smit DJA, Begeer S, Linkenkaer-Hansen K. Intellectually able adults with autism spectrum disorder show typical resting-state EEG activity. Scientific reports. 2022; 12(1): 19016.

There is broad interest in discovering quantifiable physiological biomarkers for psychiatric disorders to aid diagnostic assessment. However, finding biomarkers for autism spectrum disorder (ASD) has proven particularly difficult, partly due to high heterogeneity. Here, we recorded five minutes eyes-closed rest electroencephalography (EEG) from 186 adults (51% with ASD and 49% without ASD) and investigated the potential of EEG biomarkers to classify ASD using three conventional machine learning models with two-layer cross-validation. Comprehensive characterization of spectral, temporal and spatial dimensions of source-modelled EEG resulted in 3443 biomarkers per recording. We found no significant group-mean or group-variance differences for any of the EEG features. Interestingly, we obtained validation accuracies above 80%; however, the best machine learning model merely distinguished ASD from the non-autistic comparison group with a mean balanced test accuracy of 56% on the entirely unseen test set. The large drop in model performance between validation and testing, stress the importance of rigorous model evaluation, and further highlights the high heterogeneity in ASD. Overall, the lack of significant differences and weak classification indicates that, at the group level, intellectually able adults with ASD show remarkably typical resting-state EEG.

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13. Ma H, Cao Y, Li M, Zhan L, Xie Z, Huang L, Gao Y, Jia X. Abnormal amygdala functional connectivity and deep learning classification in multifrequency bands in autism spectrum disorder: A multisite functional magnetic resonance imaging study. Human brain mapping. 2022.

Previous studies have explored resting-state functional connectivity (rs-FC) of the amygdala in patients with autism spectrum disorder (ASD). However, it remains unclear whether there are frequency-specific FC alterations of the amygdala in ASD and whether FC in specific frequency bands can be used to distinguish patients with ASD from typical controls (TCs). Data from 306 patients with ASD and 314 age-matched and sex-matched TCs were collected from 28 sites in the Autism Brain Imaging Data Exchange database. The bilateral amygdala, defined as the seed regions, was used to perform seed-based FC analyses in the conventional, slow-5, and slow-4 frequency bands at each site. Image-based meta-analyses were used to obtain consistent brain regions across 28 sites in the three frequency bands. By combining generative adversarial networks and deep neural networks, a deep learning approach was applied to distinguish patients with ASD from TCs. The meta-analysis results showed frequency band specificity of FC in ASD, which was reflected in the slow-5 frequency band instead of the conventional and slow-4 frequency bands. The deep learning results showed that, compared with the conventional and slow-4 frequency bands, the slow-5 frequency band exhibited a higher accuracy of 74.73%, precision of 74.58%, recall of 75.05%, and area under the curve of 0.811 to distinguish patients with ASD from TCs. These findings may help us to understand the pathological mechanisms of ASD and provide preliminary guidance for the clinical diagnosis of ASD.

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14. May T, Williams K. Mother and child mental health over time in children with Autism and/or ADHD in the Longitudinal Study of Australian Children. Development and psychopathology. 2022: 1-11.

This study utilised a longitudinal population-based study to explore mother and child mental health trajectories over time from child age 0 to 14 years, between children with ASD, ADHD, or ASD + ADHD. It explored whether a bidirectional relationship between mother psychological distress and child emotional and behavioural problems (EBPs) existed. The birth cohort from the Longitudinal Study of Australian Children was used. Child EBPs were assessed using the Strengths and Difficulties Questionnaire; and mother emotional distress using the Kessler K6. Generalised estimating equations and structured equation modelling was used to understand changes over time, differences between groups and bidirectional relationships. As expected, children with ASD, ADHD or ASD + ADHD had higher EBPs than children without, and their mothers had higher levels of psychological distress across most time points, but with differing trajectories. Mothers of children with ASD (with or without ADHD) showed increasing psychological distress over time, while mothers of children with ADHD had reducing distress. The bidirectional relationship between mother and child mental health found in children without diagnoses was only partially present in children with ASD/ADHD. Findings highlight support needs and discuss implications for transactional models of parent/child emotional problems in children with neurodevelopmental disorders.

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15. Schlebusch L, Chambers N, Rosenstein D, Erasmus P, de Vries PJ. Supporting caregivers of children with developmental disabilities: Findings from a brief caregiver well-being programme in South Africa. Autism : the international journal of research and practice. 2022: 13623613221133182.

Young children with developmental disabilities and delays who live in low- and middle-income countries are at significant risk of not reaching their full potential. We know that daily interactions with their caregivers (parents or other people taking care of them) play an important role in promoting their development. However, having a child with developmental disabilities can have a negative impact on carers’ mental health and well-being, which in turn can influence their capacity to care for their children. To date, very little attention has been given to the caregivers’ capacity to care. The World Health Organization developed a Caregiver Skills Training programme which includes a brief, three-session module that focuses on improving caregivers’ well-being and mental health. This well-being programme is based on acceptance and commitment therapy. Acceptance and commitment therapy shows increasing evidence of helping people respond to their stressors, thoughts, feelings and experiences a little differently and commit to small changes that are in line with their personal values. Acceptance and commitment therapy has shown promise in improving feelings of well-being in caregivers of children with developmental disabilities. We adapted the World Health Organization Caregiver Skills Training Caregiver well-being module to suit the South African context. The resultant ‘Well Beans for Caregivers’ was then delivered to caregivers from a rural, low-resource setting in South Africa. We found the intervention easy to implement, highly acceptable to caregivers and showed promising impacts on caregivers’ well-being and mental health. This intervention has the potential to be implemented widely and sustainably to build caregivers’ capacity to care for their children.

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16. Schwichtenberg AJ, Janis A, Lindsay A, Desai H, Sahu A, Kellerman A, Chong PLH, Abel EA, Yatcilla JK. Sleep in Children with Autism Spectrum Disorder: A Narrative Review and Systematic Update. Current sleep medicine reports. 2022: 1-11.

PURPOSE OF REVIEW: Sleep problems are a common comorbidity for children with autism spectrum disorder (ASD), and research in this area has a relatively long history. Within this review, we first outline historic patterns in the field of sleep and ASD. Second, we conducted a systematic update and coded these studies based on their alignment with historic patterns. Research on ASD and sleep over the past two decades has primarily focused on four principal areas: (1) documenting the prevalence and types of sleep problems; (2) sleep problem treatment options and efficacy; (3) how sleep problems are associated with other behavioral, contextual, or biological elements; and (4) the impact of child sleep problems on families and care providers. The systematic update in this paper includes empirical studies published between 2018 and 2021 with terms for sleep and ASD within the title, keywords, or abstract. RECENT FINDINGS: In sum, 60 studies fit the inclusion/exclusion criteria and most fit within the historic patterns noted above. Notable differences included more global representation in study samples, studies on the impacts of COVID-19, and a growing body of work on sleep problems as an early marker of ASD. The majority of studies focus on correlates of sleep problems noting less optimal behavioral, contextual, and biological elements are associated with sleep problems across development for children with ASD. SUMMARY: Recommendations for future directions include continued expansion of global and age representation across samples, a shift toward more treatment and implementation science, and studies that inform our mechanistic understanding of how sleep and ASD are connected. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40675-022-00234-5.

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17. Sun F, Chen Y, Gao Q, Zhao Z. Abnormal gray matter structure in children and adolescents with high-functioning autism spectrum disorder. Psychiatry research Neuroimaging. 2022; 327: 111564.

The present study aimed to explore the brain structural mechanisms underlying clinical dysfunction in patients with ASD using magnetic resonance imaging (MRI). After screening T1 structural images from the Autism Brain Imaging Data Exchange (ABIDE) database, 111 children and adolescents with high-functioning ASD and 151 typically developing (TD) subjects matched were included in this study. We first compared the differences in gray matter volume (GMV) and gray matter density (GMD) between the two groups. Then, the relationships between GMV/GMD and clinical assessments in ASD patients were evaluated. We found that compared with the TD group, the ASD group showed increased GMV/GMD in the precuneus, thalamus, hippocampus and cingulate gyrus. Moreover, in the ASD group, social interaction was negatively correlated with GMD in the bilateral superior temporal gyrus and limbic system; communication was positively correlated with GMD in the right middle temporal gyrus, inferior frontal gyrus, and anterior cingulate gyrus; and repetitive behavior was positively correlated with GMD in the cerebellum and negatively correlated with GMV in the prefrontal cortex. In conclusion, the gray matter structure in children and adolescents with ASD was abnormal, and different clinical dysfunctions in ASD patients were related to structural abnormalities in specific regions.

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18. Wang T, Kim CN, Bakken TE, Gillentine MA, Henning B, Mao Y, Gilissen C, Nowakowski TJ, Eichler EE. Integrated gene analyses of de novo variants from 46,612 trios with autism and developmental disorders. Proceedings of the National Academy of Sciences of the United States of America. 2022; 119(46): e2203491119.

Most genetic studies consider autism spectrum disorder (ASD) and developmental disorder (DD) separately despite overwhelming comorbidity and shared genetic etiology. Here, we analyzed de novo variants (DNVs) from 15,560 ASD (6,557 from SPARK) and 31,052 DD trios independently and also combined as broader neurodevelopmental disorders (NDDs) using three models. We identify 615 NDD candidate genes (false discovery rate [FDR] < 0.05) supported by ≥1 models, including 138 reaching Bonferroni exome-wide significance (P < 3.64e-7) in all models. The genes group into five functional networks associating with different brain developmental lineages based on single-cell nuclei transcriptomic data. We find no evidence for ASD-specific genes in contrast to 18 genes significantly enriched for DD. There are 53 genes that show mutational bias, including enrichments for missense (n = 41) or truncating (n = 12) DNVs. We also find 10 genes with evidence of male- or female-bias enrichment, including 4 X chromosome genes with significant female burden (DDX3X, MECP2, WDR45, and HDAC8). This large-scale integrative analysis identifies candidates and functional subsets of NDD genes.

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19. Zhou T, Zhang C, Yi C. Caregivers and interventionists: Developing a Dual Role Behaviors Scale for parents of children with autism spectrum disorders. Family process. 2022.

The integration of the roles of caregivers and interventionists is important in parenting a child with autism spectrum disorder (ASD). However, an instrument to measure dual-role behaviors is unavailable. This study developed and validated the Dual Role Behaviors Scale for parents of autistic children (DRBS-A). Initial items were generated using the interview transcripts of a previous qualitative study. The initial scale was administered to 422 parents. Data were randomly halved to generate Samples 1 and 2. Exploratory factor analysis conducted using Sample 1 (autism spectrum disorder = 216) screened items based on factor loadings and explored the scale’s structure. Confirmatory factor analysis (CFA) conducted with Sample 2 (N = 206) examined structural validity. Among the participants, 121 (Sample 3) derived from the two samples were followed up after 1 month to examine the test-retest reliability. Convergent validity was examined with another sample of 105 parents (Sample 4). The formal version of the DRBS-A comprised 20 items across four dimensions: parental acceptance, parental disengagement, persistence in interventions, and punishment in interventions. The four-factor structure with two higher order factors was supported by the CFA results (χ(2) = 290.90, df = 165, CFI = 0.94, TLI = 0.93, RMSEA = 0.061, SRMR = 0.063). The subscales’ test-retest reliabilities ranged from 0.61 to 0.78. The internal consistencies were satisfactory (Cronbach’s αs: 0.67-0.93). Convergent validity was supported by correlations of the DRBS-A dimensions with parental involvement and positive parenting practice. Other factors related to dual-role behaviors were also explored. The DRBS-A has good validity and reliability and can be used to explore the effects of role integration.

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