DSpace Repository :: Browsing by Author "White, Susan W."

Browsing by Author "White, Susan W."

Now showing 1 - 20 of 23

Assessment and Treatment of Emotion Regulation Impairment in Autism Spectrum Disorder Across the Life Span Current State of the Science and Future Directions
(WB Saunders, 2020) Beck, Kelly B.; Conner, Caitlin M.; Breitenfeldt, Kaitlyn E.; Northrup, Jessie B.; White, Susan W.; Mazefsky, Carla A.; University of Pittsburgh; University of Alabama Tuscaloosa
Emotion regulation (ER) is the ability to modify arousal and emotional reactivity to achieve goals and maintain adaptive behaviors. ER impairment in autism spectrum disorder (ASD) is thought to underlie many problem behaviors, co-occurring psychiatric symptoms, and social impairment, and yet is largely unaddressed both clinically and in research. There is a critical need to develop ER treatment and assessment options for individuals with ASD across the life span, given the multitude of downstream effects on functioning. This article summarizes the current state of science in ER assessment and treatment and identifies the most promising measurement options and treatments.
Attention Deployment to the Eye Region of Emotional Faces among Adolescents with and without Social Anxiety Disorder
(Springer, 2021) Capriola-Hall, Nicole N.; Ollendick, Thomas H.; White, Susan W.; University of Alabama Tuscaloosa; Virginia Polytechnic Institute & State University
Background Avoidance of the eye region, especially of faces showing anger, may maintain social anxiety symptoms by negatively reinforcing expectations and fears associated with social situations. Eye-tracking research, however, has yet to explicitly examine differences in attention allocation to the eye region of emotional faces among adolescents with social anxiety disorder (SAD). Methods Gaze patterns were explored in a sample of youth with and without SAD matched on age and sex. Results Adolescents with SAD were quicker to fixate, and maintained their initial gaze longer, to the eye region, regardless of emotion, relative to teens without SAD. Group-level differences also emerged for initial fixation duration directed to the eye region of angry faces (when compared with happy faces). Conclusions These findings suggest that vigilance to the eye region of faces, especially angry faces, (when compared with happy faces) is characteristic of adolescents with SAD. Adolescents with SAD seem drawn to the eye region, more so than teens without SAD.
Brief Report: Creation of a Transition Readiness Scale for Adolescents with ASD
(Springer, 2023) Elias, Rebecca; Conner, Caitlin M.; White, Susan W.; University of Southern California; Children's Hospital Los Angeles; University of Pittsburgh; University of Alabama Tuscaloosa
The transition to postsecondary education is characterized by many changes for adolescents with autism spectrum disorder (ASD). A data-based understanding of a student's readiness for postsecondary education could help students, and their parents, better prepare for this life transition. The Transition Readiness Scale (TRS) was created to address this need. The TRS is a self/other-report questionnaire used to assess postsecondary readiness across behavioral, cognitive, and emotional domains among adolescents 15-18 years of age. The present study details measure development and provides preliminary psychometric properties in a sample of transition-aged youth with ASD. Results indicate strong internal consistency, adequate item-level analyses, and discriminant and concurrent validity. Future validation of the TRS in large-scale field testing is merited to inform clinical interpretation.
Caution When Screening for Autism among Socially Anxious Youth
(Springer, 2021) Capriola-Hall, Nicole N.; McFayden, Tyler; Ollendick, Thomas H.; White, Susan W.; University of Alabama Tuscaloosa; Virginia Polytechnic Institute & State University
Social anxiety disorder (SAD) is commonly comorbid with autism spectrum disorder (ASD). Here, in a sample of 86 children and adolescents (M-AGE = 12.62 years; 68.6% male), 28 of whom were diagnosed with ASD, 34 with SAD, and 24 with comorbid ASD and SAD, we compared parent-reported scores from the Social Responsiveness Scale-Second Edition (SRS-2; Constantino and Gruber in Social Responsiveness Scale (SRS; Constantino and Gruber2012) to determine the sensitivity and specificity of the measure in cases of differential diagnosis between SAD and ASD. Results suggest that neither the subscales, nor the SRS-2 total score, consistently differed between ASD and SAD. Sensitivity and specificity analyses suggested that the SRS-2 total poorly discriminated ASD from SAD. When screening socially anxious youth for possible ASD, caution should be taken.
Client-therapist alliance for adolescents and young adults with autism: relation to treatment outcomes and client characteristics
(University of Alabama Libraries, 2020-04) Brewe, Alexis Marie; White, Susan W.; University of Alabama Tuscaloosa
Adolescents and adults with autism spectrum disorder (ASD) experience difficulties with emotion regulation (ER), which has been associated with a host of co-occurring problems with mood, anxiety, and aggression. Although treatments targeting ER are available for individuals with ASD, there is a limited understanding of factors that lead to successful outcomes. The therapeutic alliance is considered important for outcomes in non-ASD samples; however, the process of alliance formation and its relation to treatment outcomes is unclear for clients with ASD. The present study aims to examine the trajectory of alliance formation across treatment, as well as examine whether alliance is related to treatment outcomes or specific within-person characteristics. Participants included adolescents and adults with ASD (n = 39, mean age = 15.28 years, age range = 12 to 21 years, 79.50% male) who completed a 16-week intervention designed to treat ER difficulties. Client-therapist alliance was measured at four timepoints throughout treatment using an observational measure of alliance and parents rated their child’s ER difficulties. Interrater reliability on observer-rated alliance was strong. Alliance formation significantly fluctuated throughout treatment. Overall alliance strength, as well as alliance early in treatment, predicted better treatment outcomes. Additionally, ASD symptom severity and co-occurring depression were related to alliance strength. The current study supports the importance of therapeutic alliance for clients with ASD and highlights a need for increased alliance formation during critical stages in treatment. Considerations for future research are discussed.
Community-Based Transition Support Programming for Autistic Emerging Adults
(University of Alabama Libraries, 2024) Brewe, Alexis; White, Susan W.
Becoming an independent adult is a critical life transition, characterized by new roles and responsibilities in employment, relationships, and education. For adolescents with Autism Spectrum Disorder (ASD), this transition is marked by unique challenges including unemployment/underemployment, social isolation, and difficulties living independently. Despite growing evidence of the utility of programs that prepare autistic individuals for adulthood, these programs are rarely adopted into routine clinical practice. The current study uses an implementation science approach to refine and test an existing, evidence-based transition support program, the Stepped Transition to Employment and Postsecondary Success program (STEPS) for community implementation. In Phase 1, qualitative feedback was sought from stakeholders (total n = 45; i.e., autistic adults, caregivers, and professionals involved in the adult transition process) on several barriers and facilitators to implementation of STEPS in the community. In Phase 2, STEPS was piloted with 12 autistic individuals aged 16-35 in a local community agency to examine program feasibility, acceptability, and initial clinical impact. Results supported feasibility of STEPS implementation, evidenced by 93% of treatment objectives being delivered as intended by the STEPS therapist and moderately strong therapeutic alliance (average rating = 3.29, possible range = 0-5) established with clients. Results also supported acceptability, evidenced by low attrition (91.67% retention rate), high session attendance (96.27% sessions attended as scheduled), high homework completion (84.10% homework completion), and high participant- and caregiver-reported program satisfaction (average ratings of >4 across all items, possible range 1-5). Results also partially support the clinical impact of STEPS, evidenced by clinically significant change and reliable improvement in participants' transition readiness, as well as secondary measures of adult functioning, self-knowledge, self-determination, and self-regulation. In Phase 3, participants from Phase 2 completed exit interviews to provide final input on STEPS content, which was used to prepare STEPS for community implementation. Findings informed future community implementation of STEPS, and produced a fully scalable, stakeholder-informed program that was developed to address implementation challenges and ready for community deployment. Future research could utilize innovative implementation approaches (i.e., hybrid effectiveness-implementation trials) to test strategies that might promote adoption and long-term sustainability of STEPS in communities.
Facial Affect Sensitivity Training for Young Children with Emerging CU Traits: An Experimental Therapeutics Approach
(Routledge, 2022) White, Bradley A.; Dede, Breanna; Heilman, Meagan; Revilla, Rebecca; Lochman, John; Hudac, Caitlin M.; Bui, Chuong; White, Susan W.; University of Alabama Tuscaloosa
Objective This article delineates best practices in the application of the experimental therapeutics framework for evaluating interventions within the context of randomized controlled trials (RCTs), offering a methodological primer and guiding framework for this approach. We illustrate these practices using an ongoing clinical trial conducted within the framework of a National Institute of Mental Health exploratory phased-innovation award for the development of psychosocial therapeutic interventions for mental disorders (R61/R33), describing the implementation of a novel "Facial Affect Sensitivity Training" (FAST) intervention for children with callous-unemotional (CU) traits. CU traits (e.g., lack of guilt or remorse, low empathy, shallow affect) are an established risk factor for persistent and severe youth misconduct, which reflect impairment in identified neurocognitive mechanisms that interfere with child socialization, and predict poor treatment outcomes, even with well-established treatments for disruptive behavior. Method We outline the stages, goals, and best practices for an experimental therapeutics framework. In the FAST trial, we assert that impaired sensitivity for emotional distress cues (fear and/or sadness) is mechanistically linked to CU traits in children, and that by targeting sensitivity to facial affect directly via a computerized automated feedback and incentive system, we can exert downstream effects on CU traits. Results In the context of an open pilot trial, we found preliminary support for feasibility and mechanism engagement using FAST. Conclusions We summarize pilot study limitations and how they are being addressed in the R61/R33 RCTs, as well as challenges and future directions for psychosocial experimental therapeutics.
The Impact of Support on Parents of Autistic Children
(University of Alabama Libraries, 2024) Brennan, Justine; Davis, Thompson E.
Increased caregiving demands associated with raising an autistic child have resulted in reduced social support, increased parenting stress, and decreased relationship satisfaction for parents of autistic children. While social support is protective against parental stress and can increase relationship satisfaction, few studies have examined the relationships between the support networks, functions of support (e.g., informational, emotional, and instrumental), and the well-being of parents of autistic children. This study surveyed 112 parents (73 mothers and 39 fathers) of autistic children (aged 5-12 years) to examine the relationships between (1) who was identified as a primary support person (PSP), (2) which functions of support parents perceived from their PSP, (3) how stressed parents reported they were, and (4) how satisfied parents were with their relationship with their PSP. This study was one of the first to have parents self-identify the individual upon whom they primarily rely for support, to provide a more nuanced insight into a parent's support network and support preferences. Results indicated parents most frequently identified a friend or family member as their PSP, emotional support was the most frequently identified function of support, and emotional support had the strongest association with relationship satisfaction. The results of this study provide a foundation for future studies on the implications and outcomes of support networks, functions of perceived support, and stress on the relationship satisfaction of parents of autistic children. This allows for further examination of the factors involved in developing more effective services to increase caregivers' well-being and quality of life, a severely underfunded area of research.
Improving Transition to Adulthood for Students with Autism: A Randomized Controlled Trial of STEPS
(Routledge, 2021) White, Susan W.; Smith, Isaac C.; Miyazaki, Yasuo; Conner, Caitlin M.; Elias, Rebecca; Capriola-Hall, Nicole N.; University of Alabama Tuscaloosa; Virginia Polytechnic Institute & State University; University of Pittsburgh
Emerging adulthood is a period of heightened risk for young people with autism spectrum disorder (ASD). Due in part to a lack of evidence-based services and supports during the transition to adulthood, many emerging adults fail to matriculate into postsecondary education or thrive in productive employment. The Stepped Transition in Education Program for Students with ASD (STEPS) was developed to address the psychosocial, transition-related needs of emerging adults with ASD. Adolescents and emerging adults (n =?59) with ASD were randomly assigned to either STEPS or transition as usual (TAU). Results indicate that STEPS is acceptable to young people with ASD and their parents and that it can be implemented with high fidelity. Among secondary school students, those who completed STEPS exhibited significantly greater gains in transition readiness from high school, and these gains were largely sustained after program completion. Among students enrolled in postsecondary education, STEPS resulted in increased levels of student adaptation to college relative to those in TAU. Programming to address ASD-related challenges can promote successful educational transitions.
It took a pandemic: Perspectives on impact, stress, and telehealth from caregivers of people with autism
(Pergamon, 2021) White, Susan W.; Stoppelbein, Laura; Scott, Hunter; Spain, Debbie; University of Alabama Tuscaloosa; University of London; King's College London
Shelter in place mandates due to the COVID-19 pandemic left caregivers to determine how to best meet the therapeutic requirements of their children with autism spectrum disorder (ASD). Understanding the challenges faced by families, and their experiences using telehealth for the first time, may help make services sustainable in future public health emergencies. A sample of 70 caregivers of people with ASD from across the US completed an anonymous online survey. Results indicate that impaired emotion regulation was a primary contributor of parent-reported stress for persons with ASD during the pandemic, while loss of established structure and routine contributed to parental stress. Nearly half the sample reported using telehealth for the first time. Many caregivers were appreciative that telehealth permitted continuation of services, but expressed concerns about limited effectiveness due in part to their children?s social communication problems.
Multi-level modeling with nonlinear movement metrics to classify self-injurious behaviors in autism spectrum disorder
(Nature Portfolio, 2020) Cantin-Garside, Kristine D.; Srinivasan, Divya; Ranganathan, Shyam; White, Susan W.; Nussbaum, Maury A.; Virginia Polytechnic Institute & State University; University of Alabama Tuscaloosa
Self-injurious behavior (SIB) is among the most dangerous concerns in autism spectrum disorder (ASD), often requiring detailed and tedious management methods. Sensor-based behavioral monitoring could address the limitations of these methods, though the complex problem of classifying variable behavior should be addressed first. We aimed to address this need by developing a group-level model accounting for individual variability and potential nonlinear trends in SIB, as a secondary analysis of existing data. Ten participants with ASD and SIB engaged in free play while wearing accelerometers. Movement data were collected from>200 episodes and 18 different types of SIB. Frequency domain and linear movement variability measures of acceleration signals were extracted to capture differences in behaviors, and metrics of nonlinear movement variability were used to quantify the complexity of SIB. The multi-level logistic regression model, comprising of 12 principal components, explained>65% of the variance, and classified SIB with>75% accuracy. Our findings imply that frequency-domain and movement variability metrics can effectively predict SIB. Our modeling approach yielded superior accuracy than commonly used classifiers (similar to 75 vs.similar to 64% accuracy) and had superior performance compared to prior reports (similar to 75 vs.similar to 69% accuracy) This work provides an approach to generating an accurate and interpretable group-level model for SIB identification, and further supports the feasibility of developing a real-time SIB monitoring system.
Neural Mechanisms of Facial Emotion Recognition in Autism: Distinct Roles for Anterior Cingulate and dlPFC
(Routledge, 2022) Richey, John A.; Gracanin, Denis; LaConte, Stephen; Lisinski, Jonathan; Kim, Inyoung; Coffman, Marika; Antezana, Ligia; Carlton, Corinne N.; Garcia, Katelyn M.; White, Susan W.; Virginia Polytechnic Institute & State University; Duke University; University of Alabama Tuscaloosa
Objective The present study sought to measure and internally validate neural markers of facial emotion recognition (FER) in adolescents and young adults with ASD to inform targeted intervention. Method We utilized fMRI to measure patterns of brain activity among individuals with ASD (N = 21) and matched controls (CON; N = 20) 2 s prior to judgments about the identity of six distinct facial emotions (happy, sad, angry, surprised, fearful, disgust). Results Predictive modeling of fMRI data (support vector classification; SVC) identified mechanistic roles for brain regions that forecasted correct and incorrect identification of facial emotion as well as sources of errors over these decisions. BOLD signal activation in bilateral insula, anterior cingulate (ACC) and right dorsolateral prefrontal cortex (dlPFC) preceded accurate FER in both controls and ASD. Predictive modeling utilizing SVC confirmed the utility of ACC in forecasting correct decisions in controls but not ASD, and further indicated that a region within the right dlPFC was the source of a type 1 error signal in ASD (i.e. neural marker reflecting an impending correct judgment followed by an incorrect behavioral response) approximately two seconds prior to emotion judgments during fMRI. Conclusions ACC forecasted correct decisions only among control participants. Right dlPFC was the source of a false-positive signal immediately prior to an error about the nature of a facial emotion in adolescents and young adults with ASD, potentially consistent with prior work indicating that dlPFC may play a role in attention to and regulation of emotional experience.
Providers as Stakeholders in Addressing Implementation Barriers to Youth Mental Healthcare
(Springer, 2022) Goodcase, Eric T.; Brewe, Alexis M.; White, Susan W.; Jones, Shane; University of Alabama Tuscaloosa
Research has shown that youth with mental health disorders often do not receive adequate care. School- and community-based mental health organizations are integral to implementing evidence-based mental healthcare to the vast majority of youth. It is therefore important to understand the perspectives of this stakeholder group, to determine how to improve access to high-quality care. A series of three focus groups with community mental health providers and three school counselors and social workers focus groups were conducted to get their perspective on existing barriers that prevent youth who need mental health services from being treated. A grounded theory inductive qualitative analysis revealed six major themes (Lack of Services, Lack of Knowledge, Stigma, Logistics, Poor Past Experiences with Mental Health, and Poor Coordination of Services). Each of these themes are discussed and implications are framed within the context of implementation science.
Reliability and validity of the Pediatric Anxiety Rating Scale modified for autism spectrum disorder
(Sage, 2020) Maddox, Brenna B.; Lecavalier, Luc; Miller, Judith S.; Pritchett, Jill; Hollway, Jill; White, Susan W.; Gillespie, Scott; Evans, Andrea N.; Schultz, Robert T.; Herrington, John D.; Bearss, Karen; Scahill, Lawrence; University of Pennsylvania; Ohio State University; Pennsylvania Medicine; Childrens Hospital of Philadelphia; University of Alabama Tuscaloosa; Emory University; University of California Los Angeles; University of Washington; University of Washington Seattle
Anxiety often co-occurs with autism spectrum disorder, yet there are few valid and reliable instruments for measuring anxiety in youth with autism spectrum disorder. This article describes the modification of the Pediatric Anxiety Rating Scale for youth with autism spectrum disorder and systematic psychometric evaluation in a well-characterized sample of 116 youth (age: 5-17 years) with autism spectrum disorder and a range of anxiety symptoms. The clinician-administered-Pediatric Anxiety Rating Scale for youth with autism spectrum disorder was modified with input from parents of children with autism spectrum disorder and an expert panel. Unlike many other anxiety measures, the Pediatric Anxiety Rating Scale for youth with autism spectrum disorder is more focused on behavioral manifestations of anxiety versus verbal expression. Results provide preliminary support for the psychometric properties of the Pediatric Anxiety Rating Scale for youth with autism spectrum disorder. The internal consistency of the Pediatric Anxiety Rating Scale for youth with autism spectrum disorder was 0.90. The Pediatric Anxiety Rating Scale for youth with autism spectrum disorder was strongly correlated with parent-report anxiety measures (rs = 0.62-0.68), supporting convergent validity. In support of divergent validity, correlations between the Pediatric Anxiety Rating Scale for youth with autism spectrum disorder and parent ratings of autism spectrum disorder symptoms, social withdrawal, stereotypy, hyperactivity, inappropriate speech, and repetitive behaviors were low (rs = 0.13-0.32). The Pediatric Anxiety Rating Scale for youth with autism spectrum disorder was moderately correlated with parent-reported irritability (r = 0.52). The Pediatric Anxiety Rating Scale for youth with autism spectrum disorder showed good test-retest reliability (intraclass correlation coefficient = 0.75-0.82) and inter-rater reliability (ICCs = 0.70-0.92). Overall, results support the use of the Pediatric Anxiety Rating Scale for youth with autism spectrum disorder for assessing anxiety in youth with autism spectrum disorder. Lay Abstract Many youth with autism spectrum disorder have anxiety, but it can be difficult to assess anxiety with existing measures. We modified the Pediatric Anxiety Rating Scale for youth with autism spectrum disorder and tested the new measure in a group of 116 youth (age: 5-17 years) with autism spectrum disorder. The Pediatric Anxiety Rating Scale for youth with autism spectrum disorder is an interview that a clinician usually completes with the child and parent together. We modified the interview questions and scoring instructions based on feedback from parents of children with autism spectrum disorder and from a panel of experts in autism spectrum disorder and anxiety. Unlike many other anxiety measures, the Pediatric Anxiety Rating Scale for youth with autism spectrum disorder relies less on a child's verbal expression of anxiety and more on signs that a parent can easily observe. Training clinicians to administer and score the Pediatric Anxiety Rating Scale for youth with autism spectrum disorder was uncomplicated, and raters showed excellent agreement on video-recorded interviews. Youth who were not currently in treatment for anxiety had stable Pediatric Anxiety Rating Scale for youth with autism spectrum disorder scores with repeat measurement over a 1-month period. The Pediatric Anxiety Rating Scale for youth with autism spectrum disorder is a useful clinician-rated measure of anxiety in youth with autism spectrum disorder and fills a gap for assessing anxiety in this population.
School Based Treatment for Emotional Reactivity: a Pilot Study
(University of Alabama Libraries, 2022) Golt, Josh; White, Susan W.; University of Alabama Tuscaloosa
Adolescents and adults with autism spectrum disorder (ASD) experience difficulties with emotion regulation (ER), which has been associated with a host of co-occurring problems with mood, anxiety, and aggression. Although treatments targeting ER are available for individuals with ASD, there is a limited understanding of factors that lead to successful outcomes. The therapeutic alliance is considered important for outcomes in non-ASD samples; however, the process of alliance formation and its relation to treatment outcomes is unclear for clients with ASD. The present study aims to examine the trajectory of alliance formation across treatment, as well as examine whether alliance is related to treatment outcomes or specific within-person characteristics. Participants included adolescents and adults with ASD (n = 39, mean age = 15.28 years, age range = 12 to 21 years, 79.50% male) who completed a 16-week intervention designed to treat ER difficulties. Client-therapist alliance was measured at four timepoints throughout treatment using an observational measure of alliance and parents rated their child's ER difficulties. Interrater reliability on observer-rated alliance was strong. Alliance formation significantly fluctuated throughout treatment. Overall alliance strength, as well as alliance early in treatment, predicted better treatment outcomes. Additionally, ASD symptom severity and co-occurring depression were related to alliance strength. The current study supports the importance of therapeutic alliance for clients with ASD and highlights a need for increased alliance formation during critical stages in treatment. Considerations for future research are discussed.
Sluggish cognitive tempo: An examination of clinical correlates for adults with autism
(Sage, 2020) Brewe, Alexis M.; Simmons, Grace Lee; Capriola-Hall, Nicole N.; White, Susan W.; University of Alabama Tuscaloosa
Adults with autism spectrum disorder often experience co-occurring mental health problems such as attention-deficit/hyperactivity-disorder, as well as impairments in executive function. Sluggish cognitive tempo, a cluster of behaviors including slow processing, daydreaming, and mental fogginess, has been shown to be associated with attention-deficit/hyperactivity-disorder. This study was designed to assess sluggish cognitive tempo in young adults with autism spectrum disorder. Specifically, we sought to establish a preliminary estimate of clinically significant sluggish cognitive tempo symptoms and to better understand its phenomenology and associations with executive function and psychiatric symptoms in the context of autism spectrum disorder. Young adults with autism spectrum disorder (n = 57; age 16-25 years; 84.2% male) completed a laboratory-based executive function task, and parents and participants completed measures of the participants' sluggish cognitive tempo, attention-deficit/hyperactivity-disorder, depression, and anxiety symptoms. Nearly one-third of the sample exhibited clinically impairing levels of sluggish cognitive tempo. Although sluggish cognitive tempo and attention-deficit/hyperactivity-disorder symptoms were significantly correlated, findings suggest the constructs are distinct. Results also suggest that increased sluggish cognitive tempo is related to executive function impairment and depression, but not anxiety symptoms. Considerations for assessment and long-term impacts of sluggish cognitive tempo for adults with autism spectrum disorder are discussed. Lay abstract Adults with autism spectrum disorder often experience a range of co-occurring mental health problems such as attention-deficit/hyperactivity-disorder, as well as difficulties with executive function. Sluggish cognitive tempo, a cluster of behaviors including slow processing, daydreaming, and mental fogginess, has been shown to be associated with attention-deficit/hyperactivity-disorder, and limited research has suggested that individuals with autism spectrum disorder may experience sluggish cognitive tempo. We examined co-occurring mental health problems and executive function in 57 young adults with autism spectrum disorder, aged 16-25 years to better understand sluggish cognitive tempo in autism spectrum disorder. Parents of the young adults answered questions about their children's sluggish cognitive tempo, attention-deficit/hyperactivity-disorder, depression, and anxiety symptoms, and the young adults completed tests of their executive function. Results demonstrated that nearly one-third of the sample exhibited clinically impairing levels of sluggish cognitive tempo. Although sluggish cognitive tempo and attention-deficit/hyperactivity-disorder symptoms were related, our findings suggest they are not the same constructs. Increased sluggish cognitive tempo is related to more difficulties with executive function and increased depression, but not anxiety symptoms. Results demonstrate that sluggish cognitive tempo may pose heightened difficulties for adults with autism spectrum disorder, making it an important construct to continue studying. Considerations for assessment and long-term impacts of sluggish cognitive tempo for adults with autism spectrum disorder are discussed.
Social anxiety and social cognition in youth with neurodevelopmental disorders: differential paths to functional impairment
(University of Alabama Libraries, 2019) Simmons, Grace Lee; White, Susan W.; University of Alabama Tuscaloosa
Among children with neurodevelopmental disorders, those with Autism Spectrum Disorder (ASD), Attention-Deficit Hyperactivity Disorder (ADHD), and Specific Learning Disorder (SLD) present with notable social impairment, heightened rates of social anxiety, and deficits in social cognition when compared to neurotypical peers. Because parent- and child-reports of social anxiety are frequently discrepant, conventional scientific wisdom dictates the inclusion of these separate reports when measuring symptoms and impairment. Social anxiety and social cognitive deficits are associated with poor functional outcomes, but research has minimally explored these constructs in youth with neurodevelopmental disorders. The present study examined the predictive weight of social anxiety and social cognitive impairment on adaptive functioning in a sample of 99 youth (ages: 7-17 years) with a diagnosis of ASD, ADHD, or SLD. Social cognition significantly predicted adaptive functioning impairments as well as clinician ratings of global functioning and clinical impairment. Parent and child ratings of social anxiety were significantly different; this discrepancy did not predict adaptive functioning, though it was predictive of clinician-rated impairment and approached significance in analyses of clinician-rated global functioning. These findings further clarify differential symptomatic paths to functional impairment in this population and inform mechanism-based treatment research addressing social impairment in youth with neurodevelopmental disorders.
Therapeutic Alliance Formation for Adolescents and Young Adults with Autism: Relation to Treatment Outcomes and Client Characteristics
(Springer, 2021) Brewe, Alexis M.; Mazefsky, Carla A.; White, Susan W.; University of Alabama Tuscaloosa; University of Pittsburgh
Therapeutic alliance may influence treatment outcomes for individuals with autism spectrum disorder (ASD). The present study examined the trajectory of alliance, observationally-measured at four timepoints during a 16-week mindfulness-based treatment targeting emotion regulation problems in adolescents and young adults with ASD (n = 37, mean age = 15.28, 78.40% male). Variability in alliance as a function of client characteristics and the degree to which alliance predicted emotion regulation outcomes were assessed using parent-report forms. Results demonstrate that alliance fluctuates throughout treatment. Moreover, stronger alliance predicts decreased dysphoria at posttreatment. Results also suggest that increased ASD symptom severity and depression predict weaker alliance early and throughout treatment. Findings highlight a need for clinicians to consider the importance of developing strong alliance for clients with ASD.
This may be a really good opportunity to make the world a more autism friendly place: Professionals' perspectives on the effects of COVID-19 on autistic individuals
(Elsevier, 2021) Spain, Debbie; Mason, David; Capp, Simone J.; Stoppelbein, Laura; White, Susan W.; Happe, Francesca; University of London; King's College London; South London & Maudsley NHS Trust; University of Alabama Tuscaloosa
Background: The COVID-19 (C-19) pandemic affects everyone. Autistic individuals may be at increased risk of experiencing difficulties coping with the impact of C-19 (e.g. due to unexpected changes to usual activities and routines, and the general sense of uncertainty). This preliminary study gathered the perspectives of health and social care professionals, and researchers, about: (1) vulnerability factors for coping with the pandemic; (2) the impact of the pandemic; (3) service provision during the pandemic; and (4) interventions to support reintegration during and post the pandemic. Method: We conducted an online survey, comprising Likert-scale and free text responses. Quantitative data were analysed descriptively, and qualitative data thematically. Results: Thirty-seven participants, working in clinical, education and academic settings with autistic individuals, completed the survey. C-19 had substantially impacted service provision, causing major disruption or loss of services. Thematic analysis indicated six overarching themes: (1) vulnerability factors for coping with C-19 and lockdown; (2) positive and negative impact of lockdown (for autistic individuals, families and professionals); (3) public health response to C-19; (4) service provision during the pandemic; (5) inequalities; and (6) looking to the future. Conclusions: Professionals, across disciplines and settings, must now work together with autistic individuals and their families, to understand the impact of these extraordinary circumstances and develop ways everyone can be supported more effectively.
Title IX Mandated Reporting: The Views of University Employees and Students
(MDPI, 2018) Newins, Amie R.; Bernstein, Emily; Peterson, Roselyn; Waldron, Jonathan C.; White, Susan W.; University of Central Florida; Virginia Polytechnic Institute & State University; University of Alabama Tuscaloosa
Per Title IX of the Higher Education Amendments of 1972, many university employees are mandated reporters of sexual assault. University employees (N = 174) and students (N = 783) completed an online survey assessing knowledge and opinions of this reporting requirement. University employees and students generally reported being quite knowledgeable of reporting requirements. Most university employees indicated they would report an incident disclosed by a student, but students were fairly ambivalent about whether they would disclose to faculty members. Nearly one in five students (17.2%) indicated that Title IX reporting requirements decreased their disclosure likelihood. These findings suggest that mandated reporting policies, as well as how they are presented to students and faculty, should be examined in order to increase compliance and facilitate disclosure.

Browsing by Author "White, Susan W."

Results Per Page

Sort Options