Youth with autism spectrum disorder are a vulnerable, often poorly understood patient group, who may experience periodic and chronic health challenges, in addition to their primary developmental social and communication problems. Developmental and behavioural challenges can complicate management of acute health-care needs. To date, there is an absence of empirical research exploring the hospital experiences of children and youth with autism spectrum disorder, their families and their health-care providers. Therefore, the purpose of this study was to understand these experiences in order to inform hospital-based care. A total of 42 participants were interviewed (youth with autism spectrum disorder, their parents and health-care providers) at one of two Canadian paediatric hospitals, representing 20 distinct cases of patients with autism spectrum disorder. Results from the qualitative analyses indicated that patients with autism spectrum disorder faced several challenges in the context of health-care delivery in the hospital setting, as did their families and health-care provider team. Problems identified included communication and sensory challenges, and the degree of flexibility of health-care providers and the hospital organization. Supportive health-care providers were those who acknowledged parents as experts, inquired about the requirements of patients with autism spectrum disorder and implemented strategies that accommodated the unique clinical presentation of the individual patient. These recommendations have wide-reaching utility for hospital and health-care practices involving this patient group.

BackgroundMental health problems are common among individuals with autism spectrum disorder (ASD), and difficulties with emotion regulation processes may underlie these issues. Cognitive behavior therapy (CBT) is considered an efficacious treatment for anxiety in children with ASD. Additional research is needed to examine the efficacy of a transdiagnostic treatment approach, whereby the same treatment can be applied to multiple emotional problems, beyond solely anxiety. The purpose of the present study was to examine the efficacy of a manualized and individually delivered 10‐session, transdiagnostic CBT intervention, aimed at improving emotion regulation and mental health difficulties in children with ASD.MethodsSixty‐eight children (M age = 9.75, SD = 1.27) and their parents participated in the study, randomly allocated to either a treatment immediate (n = 35) or waitlist control condition (n = 33) (ISRCTN #67079741). Parent‐, child‐, and clinician‐reported measures of emotion regulation and mental health were administered at baseline, postintervention/postwaitlist, and at 10‐week follow‐up.ResultsChildren in the treatment immediate condition demonstrated significant improvements on measures of emotion regulation (i.e., emotionality, emotion regulation abilities with social skills) and aspects of psychopathology (i.e., a composite measure of internalizing and externalizing symptoms, adaptive behaviors) compared to those in the waitlist control condition. Treatment gains were maintained at follow‐up.ConclusionsThis study is the first transdiagnostic CBT efficacy trial for children with ASD. Additional investigations are needed to further establish its relative efficacy compared to more traditional models of CBT for children with ASD and other neurodevelopmental conditions.

Objectives The current study evaluated the use of MYmind, a concurrent mindfulness program in which youth with autism and their parents simultaneously receive group specific mindfulness training. Youth with autism can experience emotional and behavioral challenges, which are associated with parental stress. Mindfulness-based programs are emerging as a promising support for these challenges, for both children and parents. While two studies have documented the use of concurrent parentchild programs, neither involve control conditions. Methods Using a within-subject repeated measures design with a baseline component, 23 parent-child dyads were assessed on mindfulness, mental health, and youth emotion regulation and autism symptoms. Participants also rated their perceived improvement on a social validity questionnaire. Results There was improvement in youth autism symptoms, emotion regulation, and adaptive skills, and in parent reports of their own mindfulness following the program. There was also some indication of a waitlist effect for parent mental health, but not for other outcome variables. Participant feedback was mainly positive. Conclusions MYmind has the potential to contribute to emotion regulation and adaptability in youth with autism, and mindfulness in parents, though more rigorous controlled trials are needed.

Most research on mental health in individuals with autism spectrum disorder (ASD) and intellectual disability (ID) has focused on deficits. We examined individual (i.e., sociocommunicative skills, adaptive behavior, functional cognitive skills) and contextual (i.e., home, school, and community participation) correlates of thriving in 330 youth with ID and ASD compared to youth with ID only, 11–22 years of age (M = 16.74, SD = 2.95). Youth with ASD and ID were reported to thrive less than peers with ID only. Group differences in sociocommunicative ability and school participation mediated the relationship between ASD and less thriving. Research is needed to further elucidate a developmental-contextual framework that can inform interventions to promote mental health and wellness in individuals with ASD and ID.

Photo-elicitation was a useful and important tool in assisting athlete participants to communicate their motivations to participate in sport in ways that using traditional verbal interviewing would not.

Children with autism spectrum disorder (ASD) often present with comorbid psychopathology including problems with emotion regulation. The goal of the present research was to investigate the feasibility of a multicomponent manualized cognitive behavior therapy treatment program for improving emotion regulation in youth with ASD 8 to 12 years of age. Thirteen males and their parents participated in the intervention, reporting high satisfaction with the activities and program overall, and attending all sessions. Preliminary outcomes regarding emotion regulation and psychopathology, and feasibility of the intervention, are summarized and discussed.Keywords. Emotion regulation, autism spectrum disorder, cognitive behavior therapy, intervention, individual therapy. EMOTION REGULATION INTERVENTION IN ASD 3 Brief Report of Preliminary Outcomes of an Emotion Regulation Intervention forChildren with Autism Spectrum Disorder Children diagnosed with autism spectrum disorder (ASD) have difficulty with sociocommunicative functioning and restricted or repetitive behaviors or interests (American Psychiatric Association, 2013) and often present with significant levels of emotional difficulties. For example, in a sample of 5 to 16-year olds with ASD and no intellectual disability, 74% had clinically significant emotional difficulties, such as anger, sadness or anxiety, compared to 18% of typically developing peers (Totsika, Hastings, Emerson, Lancaster, & Berridge, 2011). Approximately 40% to 50% of youth with ASD (as per DSM-IV-TR criteria) are estimated to meet criteria for two or more psychiatric disorders, often combining externalizing problems, such as ADHD, with internalizing problems, such as anxiety disorders (Leyfer et al., 2006;Simonoff, et al., 2008), leading many to conceptualize emotional problems as involving underlying difficulties with emotion regulation (Mazefsky et al., 2013;Mazefsky & White, 2014). Emotion regulation (ER) can be defined as ''the extrinsic and intrinsic processes responsible for monitoring, evaluating, and modifying emotional reactions, especially their intensive and temporal features, to accomplish one's goals' ' (Thompson, 1994, pp. 27-28).Considerable evidence has related poor ER to emotional problems in children with ASD, such as anxiety (e.g., Fuji et al., 2013;Wood & Gadow, 2010) One pilot study reported promising outcomes of a modified CBT program to address ER in a small sample of young children with ASD (5 in the treatment group and 6 in a delayed treatment control), 6 to 8 years of age, measured by child reported coping strategies in response to vignettes, parent reported negativity/lability and emotion regulation, and parent reported outbursts (Scarpa & Reyes, 2011). Changes though were assessed using one-tailed comparisons, potentially inflating the likelihood of finding significance.More research is needed to assess how cognitive behavioral interventions can improve ER in children with ASD. The purpose of the present study was to evaluate the preliminary clinical utility (fea...

Background: Comorbidity is common among child clinical samples. Reviews on effective intervention for comorbid problems are lacking. Method: Based on a literature search of three databases (PsycINFO, MEDLINE and ERIC), initial data analysis was carried out on 865 studies; of these,10 randomised trials fully met study inclusion criteria and were subject to final analysis, with quality assessments and effect sizes calculated. Results: Overall, effect sizes for externalising (M = 1.12) and internalising (M = 1.09) outcomes were large. Effect sizes were large for family-based (M = 1.80) compared to individual (M = 0.78) and group-based (M = 0.54) interventions. Studies with homotypic comorbidity (M= 1.18) displayed larger treatment effect sizes than ones with heterotypic comorbidity (M = 0.54). Conclusions: While the overall quality ratings of the reviewed studies varied from mediocre to good, with a variety of measures used across studies to assess the same outcomes, findings suggest that current interventions are effective for reducing internalising and externalising problems in children with comorbidity. More substantive evidence for the beneficial effects of psychosocial interventions for children with comorbid problems may arise as more robust studies, which more explicitly address and describe comorbidity, become available. Key Practitioner Message:• Comorbidity, or the co-occurrence of two or more internalising and/or externalising problems among children and youth with mental health difficulties, is common • Primary studies have reported conflicting treatment outcomes for children presenting with comorbid conditions • As comorbidity is relatively common in clinical practice, an understanding of its unique influences on intervention efforts is important • Psychosocial interventions appear to be somewhat effective for comorbid internalising and externalising problems among children

Background:  Intervention fidelity has important implications for the interpretation of intervention outcomes. Reviews on fidelity implementation for psychosocial interventions targeting children and adolescents with comorbid mental health problems are scarce. The purpose of this study was to systematically review reported fidelity of psychosocial interventions for children with comorbid mental health conditions. Method:  Fidelity and quality ratings were calculated based on an analysis of articles resulting from a previously reported systematic search of the literature (using PsycINFO, MEDLINE and ERIC databases between 1994 and 2009), using the Intervention Fidelity Assessment Checklist for the fidelity measure and the Cochrane Collaboration’s tool for assessing risk of bias for the quality measure. Results:  Overall, few studies were found to have a high level of fidelity adherence. Only 1 of the 10 studies met the ‘high’ intervention fidelity cutoff. Conclusions:  Findings suggest that current psychosocial interventions for children and adolescents with comorbid mental health disorders must be interpreted with caution, given many studies either do not measure intervention fidelity or have variable levels of fidelity adherence. Including fidelity components in future studies would aid in determining the effectiveness and generalizability of interventions targeted at children with comorbid disorders.