In this webinar, Dr. Brian Boyd provides an overview of relevant research on implicit bias and presents preliminary data examining the effects of implicit biases on racial and ethnic disparities in service access for autistic children.
Autism
The Seventy Ways That Actually Autistic People Stim
It is important to remember that language acquisition may occur differently in autistic individuals .
Remember this: You’re looking at a truck. A young child is with you, and he follows your gaze. He’s interested in the object you’re looking at, even without you pointing at it. This is called joint attention, and it is one of the primary ways children learn to connect words with objects and acquire language.
Lack of joint attention is a key characteristic of autism. Previously, it was believed that encouraging joint attention in individuals with autism would assist them in verbal expression. However, a meta-analysis of 71 autism studies challenges this assumption and suggests that individuals with autism may acquire language differently.
The authors reviewed studies on joint attention and language in autistic children since 1994. They included studies that provided clear measures of structural language, such as vocabulary size, and excluded those that only measured communication skills. In typically developing individuals, social interaction is crucial for language development. Therefore, it is reasonable to assume that the ability to establish a shared attentional frame may increase opportunities for autistic children to focus on language and participate in communicative experiences, as stated by the authors of the study.
However, their meta-analysis did not find significant language gains from interventions aimed at promoting social communication in individuals with autism.
“It is somewhat paradoxical to link language development to joint attention in autism. This is because a significant number of autistic children who become verbal still retain a diagnosis of autism, which is characterized by atypically low joint attention. For example, children with Asperger’s syndrome often develop advanced language abilities without developing equivalent social skills.”
Of the 71 studies, only 28 reported a correlation between joint attention stimulation in young autistic children and the development of simple vocabulary.
“These studies indicate that joint attention is linked to a very basic vocabulary of fewer than five words. However, they cannot predict whether the child will be able to communicate effectively by the ages of 7 or 8,” noted Mottron. Additionally, twenty-five other studies have found no correlation between joint attention and vocabulary development in children with autism.
“It is possible that autistic people learn language differently without social interaction,” he adds. “For example, in immigrant populations whose native language is not English, autistic children learn English by looking at digital tablets and never learn to speak their parents’ language.”
If some children with autism are less sensitive to the human voice than to the written word, this could open up new avenues for intervention, Mottron says. “In this case, we should redirect autistic children towards exposure to non-communicative language, in addition to talking to them.”
The study therefore opens the door to new ways of addressing neurodiversity.
Warning signs: Data indicates that autistic mothers are at higher risk for postpartum anxiety and depression.
American women have the highest rate of maternal deaths among high-income countries, with outcomes worse for minoritized groups. In a recent study published in JAMA Network Open, researchers from Drexel University’s Policy and Analytics Center in the A.J. Drexel Autism Institute examined Medicaid data to better understand and identify perinatal and postpartum outcomes among people with intellectual and developmental disabilities, including autism and intellectual disability.
Lindsay Shea, DrPH, director of the Policy and Analytics Center in the A.J. Drexel Autism Institute and lead author of the study, highlighted that while previous studies have reported an increased risk for challenges related to pregnancy and birth among people with intellectual and developmental disabilities, little research has been done using United States-based population-level data. Medicaid, as it covers almost half of births in the U.S. and a disproportionate share of people with intellectual and developmental disabilities, is a key system to study these risks and opportunities for policy and program improvements. The study revealed that people with intellectual and developmental disabilities were younger at the time of their first delivery and had higher risks for multiple medical and mental health conditions, such as gestational diabetes, gestational hypertension, and preeclampsia. Autistic pregnant individuals had a significantly higher probability of experiencing postpartum anxiety and postpartum depression compared to people with intellectual disabilities only and those without intellectual and developmental disabilities.
Researchers examined national Medicaid claims to compare perinatal and postpartum outcomes across groups of birthing people with intellectual and developmental disabilities (including intellectual disability and autism) and a random sample of birthing people without intellectual and developmental disabilities. The data included Medicaid claims from 2008-2019 for 55,440 birthing people with intellectual and developmental disabilities and a random sample of 438,557 birthing people without intellectual and developmental disabilities.
The study compared perinatal outcomes, including medical conditions like gestational diabetes, gestational hypertension, and preeclampsia, as well as mental health conditions such as anxiety disorders and depressive disorders, across different groups. Researchers used Kaplan-Meier and Cox proportional hazard regressions to estimate the likelihood of postpartum anxiety and postpartum depression.Co-author Molly Sadowsky, project director at the Policy and Analytics Center in the Autism Institute, explained that the findings suggest several opportunities for policymakers, providers, and researchers. It is important to tailor reproductive health education, perinatal care, and delivery services to provide comprehensive and targeted support for birthing individuals with intellectual and developmental disabilities. Policies should be designed and implemented to meet the needs of people with intellectual and developmental disabilities, with the goal of reducing maternal health disparities. Clinical guidelines and procedures should be adjusted to accommodate the specific needs and experiences of people with intellectual and developmental disabilities. Additionally, new Medicaid policies, such as the postpartum coverage extension and doula service reimbursement, should be evaluated for their impact on the health outcomes of people with intellectual and developmental disabilities.
“The findings of this study emphasize the urgent need for Medicaid to support birthing individuals with intellectual and developmental disabilities during the perinatal period,” said Sadowsky. “It’s crucial to address differences in access to postpartum care and coordination, as well as the related disparities in the risk of postpartum depression and anxiety.”Shea and Sadowsky also explained their plans for future work, stating, “In our next project, we will further this research by examining the impact of attitudinal and structural ableism on perinatal health and mental health outcomes, as well as on neonatal and postnatal outcomes, morbidity, and mortality among children of women with and without intellectual and developmental disabilities,” said Shea.
Shea and her research team have been granted a five-year, $3 million National Institutes of Health Research Project Grant (R01) to further investigate the impact of ableism on women with intellectual and developmental disabilities during pregnancy and the postpartum period. The upcoming study will involve a detailed examination and comparison of outcomes experienced by this group and their infants to those of peers without intellectual and developmental disabilities. Shea expressed her enthusiasm about the future of their work in this area, emphasizing the importance of supporting individuals and celebrating their birthing experiences and roles during these significant times in life.
“Integrating Positive Psychology and Autism: A Roundtable Discussion” What makes life worth living?
A new Roundtable Discussion in the peer-reviewed journal Autism in Adulthood examines the potential integration and mutual benefits of positive psychology and autism and its impact on the autism community. Click here to read the Roundtable.
The Roundtable was co-moderated by Patricia Wright, PhD, MPH, Executive Director of Proof Positive: Autism Wellbeing Alliance, and Rachel Moseley, PhD, from Bournemouth University. Expert panelists included Dan Tomasulo, PhD, from Teachers College, Columbia University; Hari Srinivasan, a PhD neuroscience student at Vanderbilt University; Jodie Wilson, BVSc, MAPP, from Latrobe University; Sara Woods, PhD, University of Washington; and Tayyab Rashid, PhD, a licensed clinical and school psychologist in Toronto.
“Positive psychology seeks to explore what brings meaning and fulfilment to life. In addition to reducing suffering, it focuses on developing tools to increase positive emotions, such as fostering meaningful relationships, discovering how to engage with life, and achieving a sense of purpose. Positive psychology can offer significant benefits to the autism community by recognizing and leveraging individual strengths. By appreciating these strengths, it can positively influence interpersonal interactions, communication dynamics, and an individual’s overall response framework.”
Rather than only addressing weaknesses, positive psychology focuses on enhancing and amplifying strengths by providing tools, techniques, and processes to leverage those strengths.