No studies to date have prospectively examined early autism spectrum disorder (ASD) markers in infants with fragile X syndrome (FXS), who are at elevated risk for ASD. This paper describes the developmental profiles of eight infants with FXS from 9 to 24 months of age. Four meet diagnostic criteria for ASD at 24 months of age, and four do not. Trends in these case studies suggest that early social-communicative deficits differentiate infants with and without later ASD diagnoses in ways that are similar to later-born siblings of children with ASD. Repetitive behaviors and cognitive and adaptive impairments are present in all FXS infants throughout development, suggesting that these deficits reflect the general FXS phenotype and not ASD in FXS specifically.

Anxiety disorders are the most prevalent disorders in children and adolescents, affecting approximately 15-20% of individuals under the age of 18 (Salum et al, 2013). Clinical subgroups, like autism spectrum disorder (ASD) and fragile X syndrome (FXS), have an elevated risk of a co-occurring anxiety disorder. Despite the elevated risk of anxiety in these groups, few research studies have investigated the rates and predictors of anxiety disorders in adolescents with these ASD and FXS. In the current study, participants included males with FXS (n=31) or ASD (n=20) aged 16 to 24. Measures included the Children's Interview for Psychiatric Symptoms-Parent Version (P-ChIPS), the Autism Diagnostic Observation Schedule-2 (ADOS-2), and the Leiter International Performance Scale-Revised (Leiter-R). Descriptive statistics indicated that 48% of the FXS adolescents met criteria for an anxiety disorder compared with 50% in ASD. Additionally, 13% of the FXS and 30% of the ASD sample met for multiple anxiety disorders. Across the FXS and ASD groups 35% versus 15% met for Specific Phobia, 12% versus 30% met for Social Phobia and 33% versus 40% met for GAD, respectively. T-tests showed no significant differences within and across groups for those meeting criteria for an anxiety disorder verses those not meeting criteria for age, NVIQ growth scores, and ASD severity. Results of the binary logistic regression did not show age, NVIQ growth scores, or ASD severity as significant predictors of any anxiety disorder across FXS and ASD. Lastly, approximately 40% of participants with FXS who met criteria for an anxiety disorder were prescribed medications for anxiety, as compared iv iv to 20% of the participants with ASD who met criteria for an anxiety disorder. Logistic regression results showed that taking anxiety medications were not significantly predictive of meeting criteria for an anxiety diagnosis however anxiety medication use was predictive of group diagnosis. Our primary finding is that approximately half of the FXS and ASD sample met for an anxiety disorder based on DSM-V criteria. Further, This study is the first that directly compares rates of anxiety disorders across adolescents and adults with FXS and idiopathic ASD within a small range of ages, intellectual ability, and autism severity. Reduced rates of anxiety disorders may be indicative of adolescent or young adult males with lower intellectual functioning who have FXS or ASD. v TABLE OF CONTENTS

Social anxiety is a common disorder that has negative impacts across multiple domains of function. Several clinical groups are at elevated risk for social anxiety, including those with fragile X syndrome and those with autism spectrum disorder. Measuring social anxiety in these clinical subgroups is fraught with challenge, however, given the complexity of social anxiety and measurement limitations that are particularly acute in persons with neurodevelopmental disorders. The over-arching aim of this study was to contribute to our understanding of the nature of social anxiety in fragile X syndrome and its association with autism spectrum disorder. To address this aim, we created a multi-faceted composite representing behavioral and biological aspects of social anxiety and examined differences in two adolescent and young adult-aged groups: 59 males with fragile X syndrome and 18 males with autism spectrum disorder. Results indicated a lower score on the multivariate composite for the males with fragile X syndrome relative to autism spectrum disorder but with evidence that traits of autism and social anxiety overlap. We conclude that measuring anxiety and autism traits in fragile X syndrome and autism spectrum disorder is complex with features that overlap and interact in a dynamic manner.

Introduction: Children affected by parental HIV are more likely than unaffected peers to experience trauma and are at-risk for negative psychological and social outcomes. This study aimed to examine the relationship between adverse childhood events and psychosocial functioning among children affected by parental HIV.Methods: A total of 790 children ages 6–17 from Henan, China were enrolled in a longitudinal, randomized controlled trial of a resilience-based psychosocial intervention. At baseline, children reported on numerous psychosocial factors, including trauma exposure, symptoms of anxiety and depression, and peer social functioning. We used linear regression analysis to test the direct effect of trauma exposure on peer social functioning. We then tested whether depression and anxiety symptoms served as two potential parallel mediators in the association between trauma exposure and peer social functioning.Results: Trauma exposure was significantly associated with poor peer social functioning (β = −0.10, p = 0.005) when controlling for key covariates. When depression and anxiety symptoms were added to the model, the association between trauma exposure and peer social functioning became nonsignificant. Instead, there were significant indirect effects from trauma exposure to peer social functioning via depression (β = −0.06, 95%CI[−0.09, −0.03]) and anxiety (β = −0.02, 95%CI[−0.04, −0.00]).Conclusion: This study is among the first to link trauma exposure to peer social functioning deficits for children affected by parental HIV and demonstrates that symptoms of anxiety and depression mediate this relationship. Findings underscore the need for comprehensive psychosocial support for children affected by HIV, including screening for trauma exposure and mental health disorders.

To determine whether adopted children with autism spectrum disorder (ASD) differ from the general ASD population in terms of diagnosis, internalizing and externalizing behaviors, sleep problems, and medications. METHODS:We studied 163 adoptees in the Autism Speaks Autism Treatment Network (ATN) in comparison with 5624 nonadopted ATN participants (aged 1.5-17.6 years; mean [SD] = 6.2 [3.4] years). Gender, age, race, ethnicity, IQ, and categorical Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, ASD diagnosis were tested for differences by group (adopted versus nonadopted) by using independent-samples t tests for continuous variables and Fisher's exact tests for categorical variables. Logistic or linear regression models were used to examine the association between adoption status and several outcome variables, after controlling for covariates. RESULTS:After controlling for demographics and diagnosis, there were significant differences in group characteristics, including greater propensity for externalizing behavior (P < .001), internalizing behavior (P = .001), and sleep problems (P < .001) in the adopted population. Adoptees were also prescribed psychotropic medications (P < .001) more often than the nonadoptees. Adoptees received a diagnosis of pervasive developmental disorder-not otherwise specified significantly more frequently than controls (odds ratio = 1.8; CI = 1.3-2.5; P < .001), despite no significant difference in symptoms on standardized measures. CONCLUSIONS:These results suggest that the population of adopted children with ASD differs from the general ASD population both with regard to diagnostic subtype and co-occurring behavioral problems. Future research should evaluate the contributions of specific factors associated with adoption such as biological family history, pregnancy history, early childhood experience, and age at adoption.