Research suggests that restricted and repetitive behaviors (RRBs) can be subdivided into repetitive sensory motor (RSM) and insistence on Sameness (IS) behaviors. However, because the majority of previous studies have used the Autism Diagnostic Interview-Revised (ADI-R), it is not clear whether these subcategories reflect the actual organization of RRBs in ASD. Using data from the Simons Simplex Collection (n=1825), we examined the association between scores on the ADI-R and the Repetitive Behavior Scale-Revised (RBS-R). Analyses supported the construct validity of RSM and IS subcategories. As in previous studies, IS behaviors showed no relationship with IQ. These findings support the continued use of RRB subcategories, particularly IS behaviors, as a means of creating more behaviorally homogeneous subgroups of children with ASD.

Objective Recently, substantial revisions to DSM-IV criteria for autism spectrum disorders (ASD) have been proposed in efforts to increase diagnostic sensitivity and specificity. This study sought to evaluate the proposed DSM5 criteria using a sample of children with PDD and non-PDD diagnoses. Methods Study participants were obtained from three large datasets, resulting in 4,453 subjects with DSM-IV clinical diagnoses of Pervasive Developmental Disorder and 690 subjects with non-PDD diagnoses (e.g., language disorder, ADHD). Items from a parent-report measure of ASD symptoms (Autism Diagnostic Interview-Revised) and from a clinical observation instrument (Autism Diagnostic Observation Schedule) were matched to DSM-5 criteria and then used to evaluate the sensitivity and specificity of the proposed criteria when compared to clinical diagnoses. Results Based on parent-report data only, the proposed DSM-5 criteria identified 91% of children with DSM-IV PDD diagnoses. Sensitivity of DSM-5 criteria remained high in specific subgroups of children with ASD, including females and children under 4. Overall, specificity of DSM-5 ASD criteria was .53, while specificity of DSM-IV ranged from .24 (PDD-NOS criteria) to .53 (Autistic Disorder criteria). When evidence of abnormality was required from both parent-report and clinical observation, specificity of DSM-5 ASD criteria increased to .63. Conclusions Based on analyses of existing symptom data, results suggest that the majority of children with current DSM-IV-based PDD diagnoses will remain eligible for an ASD diagnosis under the proposed DSM-5 criteria. Compared to DSM-IV criteria for Asperger syndrome and PDD-NOS, specificity of DSM-5 ASD criteria is improved, particularly when abnormalities are evident from both parent report and clinical observation.

Daily living skills standard scores on the Vineland Adaptive Behavior Scales-2nd edition were examined in 417 adolescents from the Simons Simplex Collection. All participants had at least average intelligence and a diagnosis of autism spectrum disorder. Descriptive statistics and binary logistic regressions were used to examine the prevalence and predictors of a "daily living skills deficit," defined as below average daily living skills in the context of average intelligence quotient. Approximately half of the adolescents were identified as having a daily living skills deficit. Autism symptomatology, intelligence quotient, maternal education, age, and sex accounted for only 10% of the variance in predicting a daily living skills deficit. Identifying factors associated with better or worse daily living skills may help shed light on the variability in adult outcome in individuals with autism spectrum disorder with average intelligence.

Lay Abstract Children with Autism Spectrum Disorder (ASD) have numerous impairments in social interaction that can severely impede mental and physical development, learning, and behavioral functioning at home and in the community and also make treatment difficult. In addition, many individuals have difficulty performing movements of the body that involve both large and small actions. We explored the role of an overlooked dimension of social interaction, social motor synchrony, in ASD, and evaluated its relationship with body movement. In particular we examined the ability of children with and without ASD to perform body movements alone or with another individual. We found that children with ASD were less able to synchronize their body with an experimenter and children with ASD performed single-person motor movements that were slower and more variable in both spacing and timing. Children with ASD had trouble performing movements that were of a consistent size and tempo over the course of the interaction. Such lack of consistency in movement likely makes coordination with another person more difficult. This raises the possibility that these types of body movements could provide new insights into understanding the social problems in ASD. Scientific Abstract Impairments in social interaction and communicating with others are core features of autism spectrum disorder (ASD) but the specific processes underlying such social competence impairments are not well understood. An important key for increasing our understanding of ASD-specific social deficits may lie with the social motor synchronization that takes place when we implicitly coordinate our bodies with others. Here, we tested whether dynamical measures of synchronization differentiate children with ASD from controls and further explored the relationships between synchronization ability and motor control problems. We found (a) that children with ASD exhibited different and less stable patterns of social synchronization ability than controls; (b) children with ASD performed motor movements that were slower and more variable in both spacing and timing; and (c) some social synchronization that involved motor timing was related to motor ability but less rhythmic synchronization was not. These findings raise the possibility that objective dynamical measures of synchronization ability and motor skill could provide new insights into understanding the social deficits in ASD that could ultimately aid clinical diagnosis and prognosis.

The current study tested the associations between peer victimization and internalizing symptoms in 54 verbally fluent adolescent males with a diagnosis of autism spectrum disorder. Adolescent- and parent-reports of multiple types of peer victimization and internalizing symptoms were used. First, the validity and reliability of the adolescent-report measure of peer victimization were successfully tested, with some exceptions. Then, structural equation models showed that adolescent-reports of peer victimization were associated with a latent construct of internalizing symptoms even after controlling for parent-reports of peer victimization. Discussion focuses on the importance of considering adolescent-reports of negative peer experience, such as peer victimization, rather than relying exclusively on parent reports.

Impairments in social interaction and communication are critical features of ASD but the underlying processes are poorly understood. An under-explored area is the social motor synchronization that happens when we coordinate our bodies with others. Here, we explored the relationships between dynamical measures of social motor synchronization and assessments of ASD traits. We found (a) spontaneous social motor synchronization was associated with responding to joint attention, cooperation, and theory of mind while intentional social motor synchronization was associated with initiating joint attention and theory of mind; and (b) social motor synchronization was associated with ASD severity but not fully explained by motor problems. Findings suggest that objective measures of social motor synchronization may provide insights into understanding ASD traits.

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Modified cognitive-behavioral therapy (MCBT) has been demonstrated to reduce anxiety in youth with autism spectrum disorder (ASD). However, non-response rates are fairly high. Few studies have investigated factors associated with response. Intolerance of uncertainty (IU) is a treatment target for anxiety and worry in neurotypical populations and has been linked to anxiety and ASD. We sought to examine whether IU affects outcomes following MCBT in 43 children, ages 8-14 years, with ASD without intellectual disability. Consistent with prior data, there was a significant reduction in parent reported anxiety following MCBT. Higher levels of pre-intervention IU predicted higher anxiety and worry pre- and post-intervention. These findings suggest that targeting IU may improve outcomes following MCBT in youth with ASD and anxiety.