The COVID‐19 pandemic has disrupted lives around the world. Autistic adults are at higher risk for co‐occurring medical and psychiatric conditions and may be more prone to difficulties adapting to pandemic‐related changes and social distancing mandates and coping with ongoing uncertainties. On the other hand, the pandemic may lead to greater understanding and acceptance of accommodations in the broader community that may facilitate supports for autistic adults beyond the pandemic. To learn more about their early pandemic experiences, online surveys were sent to independent adults enrolled in the Simons Powering Autism Research Knowledge (SPARK). The first survey was open from March 30 to April 19, 2020; a follow‐up survey sent to original responders was open from May 27 to June 6, yielding 396 participants with data for both surveys. We found that adults who were female, younger, had prior diagnoses of a mental health condition, personal COVID‐19 experience (i.e., knowing someone who had symptoms or tested positive) or less frequent hope for the future reported the greatest negative impacts. Decrease in feelings of hopefulness over time predicted greater psychological distress at T2, accounting for T1 impact and distress levels and increases in total COVID‐19 impact. Less perceived benefit of online services also predicted later distress. Although there tends to be a focus on coping with negative effects of the pandemic, mental health providers may consider approaches that focus on positives, such as fostering hope and understanding factors that facilitate benefit from online services. Lay Summary Autistic adults may be at risk for psychological distress during the COVID‐19 pandemic. The current study suggests that autistic adults who were younger, female, had a mental health diagnosis before the pandemic and knew someone who showed symptoms or tested positive for COVID‐19 reported more areas negatively impacted by COVID‐19 and greater difficulty coping with those effects. Decreases in hope over time were associated with greater psychological distress. Less perceived benefit from online services also predicted distress 2 months later. These results suggest important areas to further explore as we develop supports for autistic adults during the pandemic.
It is essential to recognize the strengths and talents of autistic individuals. Previous studies of extraordinary talents (i.e. skills that stand out relative to the general population) have combined individuals with different skills (e.g. calendrical calculation, drawing) into one group. There has been limited investigation of talents in specific areas and even less consideration of personal strengths (i.e. skills that stand out relative to that person’s other abilities, but not the general population). We extend this literature by examining the relationship between parent-reported talents and strengths and performance on standardized cognitive tests in 1470 children (4–18 years) from the Simons Simplex Collection with autism and IQ above 70. Almost half (46%) had at least one parent-reported talent and an additional 23% without extraordinary talents had at least one personal strength. Children with parent-reported talents and strengths had different cognitive profiles than children with no reported skill in visuospatial, drawing, computation, or music. Those highlighted for their memory abilities had somewhat more even verbal and nonverbal abilities, relative to children whose memory was not emphasized as a special skill. These results emphasize the importance of exploring strengths separately by domain and a need for more research in this area. Lay abstract Previous research has suggested that focusing on impairments can be detrimental to the well-being of autistic individuals, yet little research has focused on strengths and positive qualities in autism. Some studies explored “savant skills” (herein referred to as “extraordinary talents”), that is, skills that stand out compared to the general population. These often group everyone who has a specific talent, rather than exploring subgroups with strengths in specific areas. There has been even less research focused on personal strengths (i.e. skills that stand out relative to the individual’s other abilities, but not the general population). To expand this research, we use a sample of 1470 children (ages 4–18 years) from the Simons Simplex Collection without cognitive impairment to examine the relationship between having a parent-reported skill in a specific area and performance on a standardized cognitive test. Almost half (46%) had at least one parent-reported talent and an additional 23% without extraordinary talents had at least one personal strength. Children with these parent-reported skills had different patterns of performance on these standardized tests than children without skills in that area (i.e. visuospatial, drawing, computation, reading, and memory). Specific skills in computation or reading were associated with higher overall performance on the standardized tests. These results emphasize the importance of considering strengths separately by area, rather than combining individuals with different types of strengths. The high number of children with skills in this study underscores the need for more research in this area, particularly using instruments focused on understanding the nuances of these strengths. It is important for future studies to consider these skills in children with cognitive impairment.
BackgroundIndividuals diagnosed with fragile X syndrome (FXS), the most common known inherited form of intellectual disability, commonly exhibit significant impairments in social gaze behavior during interactions with others. Although this behavior can restrict social development and limit educational opportunities, behavioral interventions designed to improve social gaze behavior have not been developed for this population. In this proof of concept (PoC) study, we examined whether administering a behavioral skills training package—discrete trial instruction (DTI) plus relaxation training—could increase social gaze duration in males with FXS.MethodsAs part of a larger clinical trial, 20 boys with FXS, aged 8 to 18 years, were randomized to receive DTI plus relaxation training administered at one of two prescribed doses over a 2-day period at our research center. Potential improvements in social gaze behavior were evaluated by direct observations conducted across trials during the training, and generalization effects were examined by administering a social challenge before and after the treatment. During the social challenge, social gaze behavior was recorded using an eye tracker and physiological arousal levels were simultaneously recorded by monitoring the child’s heart rate.ResultsLevels of social gaze behavior increased significantly across blocks of training trials for six (60%) boys who received the high-dose behavioral treatment and for three (30%) boys who received the low-dose behavioral treatment. Boys who received the high-dose treatment also showed greater improvements in social gaze behavior during the social challenge compared to boys who received the low-dose treatment. There was no effect of the treatment on physiological arousal levels recorded on the heart rate monitor at either dose.ConclusionsThese results suggest that appropriate social gaze behavior can be successfully taught to boys with FXS using a standardized behavioral skills training approach. Future studies will need to evaluate whether younger children with FXS might benefit from this treatment, and/or whether more naturalistic forms of behavioral skills training might be beneficial, before social gaze avoidance becomes established in the child’s repertoire.Trial registrationClinicalTrials.gov, NCT02616796. Registered 30 November 2015.
Psychotherapy is recognised as an integral part of general psychiatric education at the level of preparation for the membership exam. Guidelines were first published over 20 years ago by the Royal Medico-Psychological Association (RMPA, 1971). In 1986 these guidelines were reviewed and clarified amid some pessimism about how widely the previous recommendations were being met (Royal College of Psychiatrists, 1986). The shortage of consultant psychotherapists and the competing demands of other service and training commitments were suggested as explanations for this.
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