1. Brickhill R, Atherton G, Piovesan A, Cross L. Autism, thy name is man: Exploring implicit and explicit gender bias in autism perceptions. PLoS One;2023;18(8):e0284013.

Males are around three times more likely to possess an autism diagnosis than females. For years this was explained by accounts that considered the male gender more compatible with the autistic phenotype. However, new research suggests that a lack of understanding and recognition of the female autistic phenotype, and a predisposition to associate males with autistic traits, could lead to structural inequalities that hinder the identification of autistic females. To explore how autism and gender are more widely perceived, the present study tested implicit and explicit associations between autism and binary gender using the Implicit Association Test (IAT) and the Autism Quotient (AQ) presented alongside a male or female vignette. A significant association was found on the IAT, identifying an implicit bias towards males and autistic traits. The vignette AQ pairing also revealed some specific items perceived as explicitly male traits, while only reverse-scored items were perceived as female. These findings suggest that current perceptions and even metrics of autism are skewed towards males, which may hinder the identification and understanding of the female autistic phenotype.

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2. Cherewick M, Daniel C, Shrestha CC, Giri P, Dukpa C, Cruz CM, Rai RP, Matergia M. Psychosocial interventions for autistic children and adolescents delivered by non-specialists in low- and middle-income countries: a scoping review. Front Psychol;2023;14:1181976.

BACKGROUND: Most autistic individuals reside in low- and middle-income countries (LMIC) and have limited access to medical providers and specialists. Support for delivery of psychosocial interventions by non-specialists is growing to address this mental health care gap. This scoping review involved a systematic analysis of studies of non-specialist delivered psychosocial interventions for children and adolescents diagnosed with autism and living in low- and middle-income countries. METHODS: The primary objective of this review was to identify psychosocial interventions for autistic children and adolescents in LMIC delivered by non-specialists (parent, teacher, peer, community, multi-level) and to summarize resulting effects on targeted outcomes. The search strategy was completed in four databases with predetermined inclusion and exclusion criteria. The systematic search generated 3,601 articles. A total of 18 studies met inclusion/exclusion criteria. Data extraction was completed, and results summarized by; (1) participant sample; (2) intervention procedures; (3) implementation by non-specialists; (4) effect on evaluated outcomes; and (5) assessment of risk of bias. Studies examined a range of child and adolescent outcomes including assessment of communication skills, social skills, motor skills, functional and adaptive behaviors, emotional regulation, attention and engagement, sensory challenges, depression, anxiety, and quality of life. Several studies also evaluated intervention effects on family relationships, parent/caregiver stress and parent/caregiver mental health. RESULTS: Collectively, the 18 studies included a total of 952 ASC participants ranging in age from 2 to 16 years. Of the included studies, 8 studies were parent/caregiver-mediated, 1 study was peer-mediated, 2 studies were teacher-mediated, and 7 studies included multi-level non-specialist mediated components. Effects on evaluated outcomes are reported. CONCLUSION: Non-specialist delivered interventions for autistic children and adolescents are effective for an array of outcomes and are particularly well suited for low- and middle-income countries. Implications for future research are discussed.

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3. Fakheir Y, Khalil R. The effects of abnormal visual experience on neurodevelopmental disorders. Dev Psychobiol;2023 (Sep);65(6):e22408.

Normal visual development is supported by intrinsic neurobiological mechanisms and by appropriate stimulation from the environment, both of which facilitate the maturation of visual functions. However, an offset of this balance can give rise to visual disorders. Therefore, understanding the factors that support normal vision during development and in the mature brain is important, as vision guides movement, enables social interaction, and allows children to recognize and understand their environment. In this paper, we review fundamental mechanisms that support the maturation of visual functions and discuss and draw links between the perceptual and neurobiological impairments in autism spectrum disorder (ASD) and schizophrenia. We aim to explore how this is evident in the case of ASD, and how perceptual and neurobiological deficits further degrade social ability. Furthermore, we describe the altered perceptual experience of those with schizophrenia and evaluate theories of the underlying neural deficits that alter perception.

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4. Furnier SM, Ellis Weismer S, Rubenstein E, Gangnon R, Rosenberg S, Nadler C, Wiggins LD, Durkin MS. Using adaptive behavior scores to convey level of functioning in children with autism spectrum disorder: Evidence from the Study to Explore Early Development. Autism;2023 (Aug 23):13623613231193194.

Autistic people are often described as « low- » or « high-functioning » based on their scores on cognitive tests. These terms are common in publications and in everyday communication. However, recent research and feedback from the autistic community suggests that relying on cognitive ability alone to describe functioning may miss meaningful differences in the abilities of autistic children and adults and in the kinds of support they may need. Additional methods are needed to describe « functioning » in autistic children. We examined whether scores from a test measuring adaptive behaviors would provide information on the functional abilities of children with autism that is different from cognitive ability and autism symptom severity. Adaptive behaviors include age-appropriate skills that allow people to function in their everyday lives and social interactions. We found that a large amount of the variation in adaptive behavior scores was not explained by cognitive development, autism symptom severity, and behavioral and emotional problems. In addition, there was a wide range of adaptive ability levels in children with autism in our study, including in those with low, average, or high cognitive scores. Our results suggest that adaptive behavior scores could provide useful information about the strengths and support needs of autistic children above and beyond measures of cognitive ability and autism symptom severity. Adaptive behavior scores provide important information on the needs of autistic people.

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5. Hussain A, John JR, Dissanayake C, Frost G, Girdler S, Karlov L, Masi A, Alach T, Eapen V. Sociocultural factors associated with detection of autism among culturally and linguistically diverse communities in Australia. BMC Pediatr;2023 (Aug 23);23(1):415.

BACKGROUND: The age at which parents or caregivers first develop concerns about their child’s development has significant implications on formal diagnosis and intervention. This study aims to determine the sociocultural factors that are associated with the age and type of first concern reported by parents of autistic children among culturally and linguistically diverse (CALD) communities in Australia. We also assessed whether sociocultural factors predict autism traits measured in terms of social affect (SA), restricted and repetitive behaviours (RRB), and calibrated severity scores (CSS). METHODS: This study is a secondary data analysis of the data collected from six Autism Specific Early Learning and Care Centres (ASELCCs) as part of the Autism Co-operative Research Centre (CRC) program between 2015 and 2019. Data analysed in this study included a family history questionnaire with sociodemographic and sociocultural information, parent-reported age and type of first concern, and clinician/researcher administered Autism Diagnostic Observation Schedule – Second Edition (ADOS-2) which includes standardised domain-wise scores of social affect (SA) and restricted and repetitive behaviours (RRB) as well as calibrated severity scores (CSS), a measure of severity of autism. Primary analysis included multivariable linear regression models to examine the predictive influence of sociodemographic and sociocultural factors on the dependant variables of age of concern (AOC) and the autism traits (SA, RRB, and CSS). RESULTS: The mean AOC in the sample was 18.18 months and the most common concerns were speech/language delay, limited social interaction, and hyperactivity/behavioural changes. The multivariable linear regression models showed factors such as increase in age of child, those from a CALD background, annual family income, sibling’s autism diagnosis, and developmental concerns to be significantly associated with parental AOC. Additionally, we also found that increase in child’s age and CALD status to be significant predictors of autism trait (RRB) and severity measured in terms of the CSS score. Further, females (compared to males) were associated with higher difficulties with social communication and interaction skills. CONCLUSION: Understanding key factors that contribute to early identification of autism can help tailor awareness programs for parents and caregivers, whilst also informing the development of services focused on serving all CALD communities.

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6. Kildahl AN, Helverschou SB. Post-traumatic stress disorder and experiences involving violence or sexual abuse in a clinical sample of autistic adults with intellectual disabilities: Prevalence and clinical correlates. Autism;2023 (Aug 23):13623613231190948.

Post-traumatic stress disorder is a mental health disorder that may be triggered by the experience of events perceived as terrifying or overwhelming. Examples of such events include being the victim of violence or sexual abuse. Compared with other people, autistic people have increased risk of being exposed to violence or sexual abuse. In addition, autistic people may be more vulnerable to developing post-traumatic stress disorder following such exposure. However, knowledge is limited concerning the prevalence of experiences involving violence and sexual abuse, and post-traumatic stress disorder, in autistic people with co-occurring intellectual disabilities. Detection of these experiences, and identification of post-traumatic stress disorder, may be challenging in these individuals, and previous research indicates that post-traumatic stress disorder symptoms may be overlooked or misinterpreted. In this study, we examined prevalence of post-traumatic stress disorder, violence and sexual abuse in a clinical sample of 88 autistic adults with intellectual disabilities referred for mental health assessment. Only 3.4% were diagnosed with post-traumatic stress disorder, even if experiences involving violence (34.1%) or sexual abuse (17.0%) were common. Anxiety and affective disorders were common diagnoses among participants with these experiences. Controlling for autism characteristics, level of intellectual disability and communication skills, experiences of violence/sexual abuse were found to be associated with a measure of ‘challenging’ behaviours. These results indicate that potentially traumatic experiences are common in autistic adults with intellectual disabilities referred for mental health assessment, and that post-traumatic stress disorder may be under-recognised. The findings highlight the importance of trauma screening and post-traumatic stress disorder assessment, as well as the importance of trauma-informed care, in this population.

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7. Komisarek O, Malak R, Śledzińska A, Śledzińska P, Mojs E, Matthews-Kozanecka M, Samborski W. The use of botulinum toxin for grinding in patients with Rett syndrome-Case report. Spec Care Dentist;2023 (Aug 22)

AIMS: Rett syndrome (RTT) is a neurodevelopmental disorder caused by a mutation in the methyl-CpG-binding protein 2 (MECP2) gene. It is characterized by profound and severe motor disability. Patients with RTT grind their teeth, causing damage to their permanent teeth. This article aims to describe the case of an 8-year-old child with RTT and the methods of botulinum toxin-based treatment for teeth grinding. METHODS AND RESULTS: Surface electromyography (sEMG) was used to monitor the effects of treatment. The masseter and temporal muscles, responsible for the elevation of the mandible, were injected with botulinum toxin. The results of the sEMG examination performed 1 week, 1 month and 4 months after toxin administration were compared to the sEMG conducted before treatment. The research demonstrates a significant reduction in both grinding frequency and tension of the masseter and temporal muscles. CONCLUSION: Possible adverse effects after chronic use of botulinum toxin were discussed. The article also emphasizes the need for masticatory muscle rehabilitation during botulinum toxin therapy. However, it is necessary to repeat this procedure on a larger group of children with RTT to establish our efforts’ efficacy.

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8. Lee CM, Altschuler MR, Esler AN, Burrows CA, Hudock RL. Why are only some children with autism spectrum disorder misclassified by the social communication questionnaire? An empirical investigation of individual differences in sensitivity and specificity in a clinic-referred sample. J Neurodev Disord;2023 (Aug 22);15(1):28.

BACKGROUND: The Social Communication Questionnaire (SCQ) is a checklist for autism spectrum disorder (ASD) commonly used in research and clinical practice. While the original validation study suggested that the SCQ was an accurate ASD screener with satisfactory sensitivity and specificity, subsequent studies have yielded mixed results, with some revealing low sensitivity, low specificity, and low utility in some settings. METHOD: The present study examined the psychometric properties of the SCQ as well as the individual difference characteristics of 187 individuals with and without autism spectrum disorder (ASD) who were misclassified or accurately classified by the SCQ in a clinic-referred sample. RESULTS: The SCQ showed suboptimal sensitivity and specificity, regardless of age and sex. Compared to true positives, individuals classified as false positives displayed greater externalizing and internalizing problems, whereas individuals classified as false negatives displayed better social communication and adaptive skills. CONCLUSIONS: The findings suggest that non-autistic developmental and behavioral individual difference characteristics may explain high rates of misclassification using the SCQ. Clinicians and researchers could consider using the SCQ in combination with other tools for young children with internalizing and externalizing symptoms and other more complex clinical presentations.

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9. Little LM, Cohen SR, Tomchek SD, Baker A, Wallisch A, Dean E. Interventions to Support Social Participation for Autistic Children and Adolescents in Homes and Communities (2013-2021). Am J Occup Ther;2023 (Mar 1);77(Suppl 1)

Systematic review briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association’s Evidence-Based Practice Program. Each systematic review brief summarizes the evidence on a theme related to a systematic review topic. This systematic review brief presents findings to support social participation for autistic1 children and adolescents (birth to 18 yr) in homes and communities.

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10. Molinaro G, Bowles JE, Croom K, Gonzalez D, Mirjafary S, Birnbaum S, Razak KA, Gibson JR, Huber KM. Female specific dysfunction of sensory neocortical circuits in a mouse model of autism mediated by mGluR5 and Estrogen Receptor α. bioRxiv;2023 (Aug 10)

Autism manifests differently in males and females and the brain mechanisms that mediate these sex-dependent differences are unknown. Here, we demonstrate that deletion of the ASD-risk gene, Pten, in neocortical pyramidal neurons ( (NSE) Pten KO) results in robust hyperexcitability of local neocortical circuits in female, but not male, mice, observed as prolonged, spontaneous persistent activity states (UP states). Circuit hyperexcitability in females is mediated by enhanced signaling of metabotropic glutamate receptor 5 (mGluR5) and estrogen receptor α (ERα) to ERK and de novo protein synthesis. In support of this idea, Pten deleted cortical neurons have a female-specific increase in mGluR5 levels and mGluR5-driven protein synthesis rates, mGluR5-ERα complexes are elevated in female cortex and genetic reduction of ERα in Pten KO cortical neurons rescues circuit excitability, protein synthesis rates and enhanced neuron size selectively in females. Abnormal timing and hyperexcitability of neocortical circuits in female (NSE) Pten KO mice are associated with deficits in temporal processing of sensory stimuli and social behaviors as well as mGluR5-dependent seizures. Female-specific cortical hyperexcitability and mGluR5-dependent seizures are also observed in a human disease relevant mouse model, germline Pten +/-mice. Our results reveal molecular mechanisms by which sex and a high impact ASD-risk gene interact to affect brain function and behavior.

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11. Northrup RA, Jones E, Singh V, Holingue C, Meck M, Gurnett CA, van Stone M, Kalb LG. Caregiver perspectives on the continued impact of the COVID-19 pandemic on children with intellectual/developmental disabilities. Front Pediatr;2023;11:1196275.

The COVID-19 pandemic has significantly impacted caregivers, especially those raising a child with an intellectual/developmental disability (IDD). While research has shown substantial disruption to the family, school, and occupational lives of the IDD community, little is known about the long-term impacts of COVID-19. To address this question, 249 caregivers were surveyed via an online questionnaire, between April and August of 2022 (more than 2 years into the pandemic) about potential impacts of the COVID-19 pandemic on their child’s access to health- and school-based therapeutic services, caregiver mental health, and family life. The majority of caregivers reported disruptions in access to and quality of school-based therapeutic services for their child as well as a reduction in educational accommodations in the 2021-2022 academic year. Nearly half of caregivers reported feeling anxious and almost a quarter reported feeling depressed for the majority of their days. More than half of respondents reported decreased social support, and one-fifth reported employment disruptions and decreased access to food. These findings suggest that families of children with IDD are still experiencing ongoing negative impacts of the pandemic, emphasizing the critical need for continued support in the wake of the initial and more obvious disruptions caused by the COVID-19 outbreak.

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12. Orland K, Harvey K, Klinkerman LN, Corrales A, Jamnik A, Zale C, Jo CH, Rathjen K, McIntosh A, Petrasic J, Sucato DJ, Ramo B, Johnson M, Brooks JT. An Analysis of Scoliosis in Autism Spectrum Disorder. J Pediatr Orthop;2023 (Aug 23)

BACKGROUND: Children with autism/Asperger are grouped into the diagnosis of autism spectrum disorder (ASD). It remains uncertain whether children with ASD and scoliosis have radiographic and clinical outcomes similar to idiopathic scoliosis (IS) patients. METHODS: A single-center, retrospective review of a prospective scoliosis registry evaluated patients who had a posterior spinal fusion±Anterior Spinal Fusion and an underlying diagnosis of ASD between 1990 and 2021. A 2:1 match with AIS patients by age and sex was compared using demographic, radiographic, intraoperative, and SRS-22/30 variables. RESULTS: Thirty patients with ASD (63% male, mean age at surgery 14.6±2.5 y) met inclusion criteria, with a follow-up of 2.46±1.00 years. Despite no differences in curve magnitude preoperatively, patients with ASD had a higher percent correction at 2-year follow-up (66% vs. 57%, P=0.01) and improved mean curve magnitude (20±10 degrees) at 2-year follow-up compared with IS patients (27±11 degrees, P<0.01). ASD patients had less lumbar lordosis preoperatively (40±12 vs. 53±14, P<0.01), but there were no significant differences in sagittal parameters at 2-year follow-up. There were no significant differences in the rate of complications at 2-year follow-up between ASD and AIS cohorts. CONCLUSIONS: Although patients with ASD exhibited decreased lordosis compared with IS patients preoperatively, their radiographic outcomes at 2-year follow-up were the same. In addition, ASD patients maintained greater curve correction than IS patients at 2 years follow-up. LEVEL OF EVIDENCE: Prognostic retrospective study.

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13. Quillet JC, Siani-Rose M, McKee R, Goldstein B, Taylor M, Kurek I. A machine learning approach for understanding the metabolomics response of children with autism spectrum disorder to medical cannabis treatment. Sci Rep;2023 (Aug 22);13(1):13022.

Autism spectrum disorder (ASD) is a neurodevelopmental condition impacting behavior, communication, social interaction and learning abilities. Medical cannabis (MC) treatment can reduce clinical symptoms in individuals with ASD. Cannabis-responsive biomarkers are metabolites found in saliva that change in response to MC treatment. Previously we showed levels of these biomarkers in children with ASD successfully treated with MC shift towards the physiological levels detected in typically developing (TD) children, and potentially can quantify the impact. Here, we tested for the first time the capabilities of machine learning techniques applied to our dynamic, high-resolution and rich feature dataset of cannabis-responsive biomarkers from a limited number of children with ASD before and after MC treatment and a TD group to identify: (1) biomarkers distinguishing ASD and TD groups; (2) non-cannabinoid plant molecules with synergistic effects; and (3) biomarkers associated with specific cannabinoids. We found: (1) lysophosphatidylethanolamine can distinguish between ASD and TD groups; (2) novel phytochemicals contribute to the therapeutic effects of MC treatment by inhibition of acetylcholinesterase; and (3) THC- and CBD-associated cannabis-responsive biomarkers are two distinct groups, while CBG is associated with some biomarkers from both groups.

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14. Sakka S. Rob’Autism Project: Social Learning at the Center of the Therapy. Stud Health Technol Inform;2023 (Aug 23);306:340-347.

Rob’Autism project was started in 2014, it aims at setting a therapy support for ASD (Autistic Spectrum Disorder) teenagers based on robot, art and culture mediations. The objective of the therapy support is to improve social skills. At its center is the improvement of the capacity to build and destroy affective links with the environment, or generate and drop communication relation with the external world. Three points were addressed to restore social links management: individual, collective and social communication. The experiments were organized in 20 working sessions of 1 hour per week and involved 6 teenagers, 3 robots and 6 accompanying people. During the sessions, a repetitive scenario is performed proposing a fixed frame in which controlled events can occur, in such way that the subjects environment remains simplified. During the 20 sessions, the subjects are supervised to build a show, which is presented to an external public. Up to now, eight groups were studied (48 subjects in total by groups of 6). The results show a redefinition of the subjects’ identity and their legitimacy as members of the society.

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15. Vincent C, Bertrand-Ouellet J, Julien-Gauthier F, Dumont FS, Desmarais C, Lecours A, Poulin V, Kiss J, Hu T, Blouin L. Design of Instructional Videos for People with Autism Who Want to Learn About Grocery Store Work: A Community, Business, Educational and Health Partnership. Stud Health Technol Inform;2023 (Aug 23);306:334-339.

To facilitate the integration of people with autism into the food industry labour market, this cross sectoral project aimed to design, validate and test instructional videos to concretely demonstrate various tasks in the grocery store, and to probe interest and assess knowledge about these tasks. Results are the delivery of 21 instructional videos validated for individuals with autism and 21 for mentors in grocery.

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16. Vincent C, Mercure F, Dumont F, Lemieux M, Caouette M, Letscher S, Boucher N, Julien-Gauthier F, Bertrand-Ouellet J. Intersectoral Development of an Evaluation Tool for the Socio-Professional Rehabilitation Process Adapted to People with Autism. Stud Health Technol Inform;2023 (Aug 23);306:311-317.

Since there was no French tool adapted to the reality of people with autism enrolled in a work integration program in Quebec, we have modified the Profile of Rehabilitation and Adaptation in a Work Context for People with Intellectual Disabilities according to the scientific literature on autism. Content validity (n=17) and applicability (n=5) were done with success. Result is an Excel compiler containing 3 informative tabs, 10 tabs on the dimensions of work rehabilitation (59 items) and 4 tabs used to compile the results. Socio-professional practicians are welcomed to use this new tool to pursue construct and internal validity.

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17. Wang X, Delgado J, Marchesotti S, Kojovic N, Sperdin HF, Rihs TA, Schaer M, Giraud AL. Speech reception in young children with autism is selectively indexed by a neural oscillation coupling anomaly. J Neurosci;2023 (Aug 18)

Communication difficulties are one of the core criteria in diagnosing ASD, and are often characterized by speech reception difficulties, whose biological underpinnings are not yet identified. This deficit could denote atypical neuronal ensemble activity, as reflected by neural oscillations. Atypical cross-frequency oscillation coupling, in particular, could disrupt the joint tracking and prediction of dynamic acoustic stimuli, a dual process that is essential for speech comprehension. Whether such oscillatory anomalies already exist in very young children with ASD, and with what specificity they relate to individual language reception capacity is unknown. We collected neural activity data using electroencephalography (EEG) in 64 very young children with and without ASD (mean age 3; 17 females, 47 males) while they were exposed to naturalistic-continuous speech. EEG power of frequency bands typically associated with phrase-level chunking (delta, 1-3 Hz), phonemic encoding (low-gamma, 25-35 Hz), and top-down control (beta, 12-20 Hz) were markedly reduced in ASD relative to typically developing (TD) children. Speech neural tracking by delta and theta (4-8 Hz) oscillations was also weaker in ASD compared to TD children. After controlling gaze-pattern differences, we found that the classical theta/gamma coupling was replaced by an atypical beta/gamma coupling in children with ASD. This anomaly was the single most specific predictor of individual speech reception difficulties in ASD children. These findings suggest that early interventions (e.g., neurostimulation) targeting the disruption of beta/gamma coupling and the upregulation of theta/gamma coupling could improve speech processing coordination in young children with ASD and help them engage in oral interactions.Significance StatementVery young children already present marked alterations of neural oscillatory activity in response to natural speech at the time of ASD diagnosis.Hierarchical processing of phonemic- and syllabic-range information (theta/gamma coupling) is disrupted in ASD children.Abnormal bottom-up (low-gamma) and top-down (low-beta) coordination specifically predicts speech reception deficits in very young ASD children, and no other cognitive deficit.

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18. Wang Y, Guo D, Wang M, Hu M, Zhu D, Yu Q, Li Z, Zhang X, Ding R, Zhao M, He P. Community-based integrated care for patients with diabetes and depression (CIC-PDD): study protocol for a cluster randomized controlled trial. Trials;2023 (Aug 22);24(1):550.

BACKGROUND: Managing the multimorbidity of diabetes and depression remains a clinical challenge for patients and healthcare professionals due to the fragmented healthcare delivery system. To effectively cope with multimorbidity, there is an urgent need for the health system to transform into people-centered integrated care (PCIC) system globally. Therefore, this paper describes the protocol of community-based integrated care for patients with diabetes and depression (CIC-PDD) project, an integrated and shared-care intervention project. METHODS/DESIGN: CIC-PDD project is conducted in two phases, namely « care model development » and « implementation and evaluation. » In the first phase, CIC-PDD model was designed and developed based on the four criteria of collaborative care model (CCM) and was subsequently adjusted to align with the context of China. The second phase entails a pragmatic, two-arm, cluster randomized controlled implementation trial, accompanied by parallel mixed-methods process evaluation and cost-effectiveness analysis. DISCUSSION: We anticipate CIC-PDD project will facilitate the development and innovation of PCIC model and related theories worldwide, particularly in low- and middle-income countries (LMICs). In addition, CIC-PDD project will contribute to the exploration of primary health care (PHC) in addressing the multimorbidity of physical and mental health issues. TRIAL REGISTRATION: ClinicalTrials.gov registration ChiCTR2200065608 (China Clinical Trials Registry https://www.chictr.org.cn ). Registered on November 9, 2022.

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19. Wilkinson E, Rinaldi ML, Christodulu KV. Predicting Self-Esteem and Depressive Symptoms from Social Skills Among Youth Referred for an Autism Evaluation. Child Psychiatry Hum Dev;2023 (Aug 22)

Social skills are associated with depression and self-esteem in autistic youth. Minimal comparisons between youth and parent-reported social skills to clinically relevant samples limit existing studies. This study compared the relationships between parent and youth-reported social skills, self-esteem, and depressive symptoms between autistic youth and youth referred for but not given an autism diagnosis. Regression analyses of cross-sectional data revealed that youth-reported social skills statistically predicted self-esteem, parent-reported social skills statistically predicted depressive symptoms, and self-esteem statistically predicted depressive symptoms. All relationships were weaker in the autistic group, except parent-reported social skills and depressive symptoms, which was stronger. Results indicate that poor social skills are associated with mental health outcomes among youth referred for autism diagnosis, but that autism-related factors may influence these relationships. Implications for future research and clinical practice are discussed.

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