文章

A matter of precision? Scene imagery in individuals with high-functioning autism spectrum disorder

作者：Larissa L. Faustmann，Mareike Altgassen

摘要 The ability to create mental representations of scenes is essential for remembering, predicting, and imagining. In individuals with autism spectrum disorders (ASD) this ability may be impaired. Considering that autistic characteristics such as weak central coherence or reduced communication abilities may disadvantage autistic

participants in traditional imagery tasks, this study attempted to use a novel task design to measure the ability of scene imagery. Thirty high-functioning adults with ASD and 27 non-autistic matched control adults were asked to describe imagined fictitious scenes using two types of scene imagery tasks. In a free imagery task, participants were asked to imagine a scene based on a given keyword. In a guided imagery task, participants had to imagine a scene based on a detailed description of the scene. Additionally, narrative abilities were assessed using the Narrative Scoring Scheme. Statistical analyses revealed no group effects in the free and guided imagery of fictional scenes. Participants with ASD performed worse than control participants in the narrative task. Narrative abilities correlated positively with performance in both imagery tasks in the ASD group only. Hence, individuals with ASD seem to show as good imagery abilities as non-autistic individuals. The results are discussed in the light of the differences between imagery and imagination and possible gender differences.

Lay Summary

The ability to imagine is an essential basis for a wide range of cognitive functions such as thinking about the future, remembering past information, or fantasizing about (im)possible events. Previous studies suggest impairments in imagery abilities in individuals with autism spectrum disorders. However, we hypothesize that the traditional task designs used in past studies may have disadvantaged individuals with autism spectrum disorder (ASD) given the tasks’ high demands on fantasy, verbal ability, and central coherence which are often compromised in ASD.Using a novel approach—taking the characteristic neural processing style in ASD into account—, we aim to re-examine imagery in this population.

摘要  创造场景的心理表征的能力对于记忆、预测和想象是必不可少的。在患有自闭症谱系障碍(ASD)的人中，这种能力可能会受到损害。考虑到自闭症患者的特点，如中枢连贯性较弱或沟通能力降低，在传统表象任务中可能会对自闭症参与者不利，本研究尝试使用一种新颖的任务设计来测量场景表象能力。30名患有自闭症的高功能成年人和27名非自闭症对照成年人被要求使用两种类型的场景想象任务描述想象的虚构场景。在一项自由成像任务中，参与者被要求根据给定的关键字想象一个场景。在引导式成像任务中，参与者必须根据场景的详细描述来想象场景。此外，还使用叙事评分方案评估了叙事能力。统计分析表明，在虚构场景的自由和引导意象中，没有群体效应。患有自闭症的参与者在叙事任务中的表现比对照参与者差。只有自闭症组的叙事能力与两种表象任务的表现呈正相关。因此，自闭症患者的表象能力似乎和非自闭症患者一样好。根据表象和想象之间的差异以及可能的性别差异对结果进行了讨论。

想象能力是一系列认知功能的重要基础，如思考未来、记住过去的信息或幻想可能发生的事件。先前的研究表明，自闭症谱系障碍患者的表象能力存在损害。然而，我们假设，过去研究中使用的传统任务设计可能对自闭症谱系障碍(ASD)患者不利，因为这些任务对幻想、言语能力和中央一致性的要求很高，而ASD往往会损害这些要求。使用一种新的方法–考虑到ASD特有的神经处理方式–我们的目标是重新检查这一人群中的图像。

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Observational learning of atypical biological kinematics in autism

Nathan C. Foster1，Simon J. Bennett， Kiri Pullar1，Joe Causer et al.

Observing and voluntarily imitating the biological kinematics displayed by a

model underpins the acquisition of new motor skills via sensorimotor processes linking perception with action. Differences in voluntary imitation in autism could be related to sensorimotor processing activity during action-observation of biological motion, as well as how sensorimotor integration processing occurs across imitation attempts. Using an observational practice protocol, which minimized the active contribution of the peripheral sensorimotor system, we examined the contribution of sensorimotor processing during action-observation. The data showed that autistic participants imitated both the temporal duration and atypical kinematic profile of the observed movement with a similar level of accuracy as neurotypical participants. These findings suggest the lower-level perception-action processes responsible for encoding biological kinematics during the action observation phase of imitation are operational in autism. As there was no task-specific engagement of the peripheral sensorimotor system during observational practice, imitation difficulties in autism are most likely underpinned by sensorimotor integration issues related to the processing of efferent and (re)afferent sen-

sorimotor information during trial-to-trial motor execution.

Lay Summary

Learning a skill by imitating a model (i.e., teacher, parent, or carer) occurs in many everyday situations such as a classroom or home. Imitation can be difficult for some autistic people, especially if a skill is new or complex. These difficulties are said to be based on how autistic people watch a skill and subsequently process what they watched in order to imitate the skill. In this study, we tasked autistic people to learn a new skill by only watching (not imitating) a model during a period of practice. Autistic people imitated how the model moved (movement time and style) similarly to non-autistic people. This finding is very important because it showed that the reported difficulty in imitation is not based on how autistic people watch and process a model (i.e., how they move), but a result of sensory-motor difficulties related to how they plan and get ready to imitate a model. Parents/carers, clinicians, teachers, and/or support workers should therefore consider autistic motor difficulties when teaching new motor skills and everyday skills via modeling.

摘要  观察和自愿地模仿模型所显示的生物运动学是通过将感知与行动联系起来的感觉运动过程来获得新的运动技能的基础。自闭症患者自愿模仿的差异可能与动作-观察生物运动过程中的感觉运动加工活动有关，以及感觉运动整合加工是如何在模仿尝试中发生的。使用观察练习方案，将外周感觉运动系统的积极贡献降至最低，我们检查了感觉运动处理在动作观察中的贡献。数据显示，自闭症参与者模仿观察到的运动的时间持续时间和非典型运动学特征，其准确度与神经典型参与者相似。这些发现表明，在模仿的动作观察阶段，负责编码生物运动学的较低水平的知觉-行动过程在自闭症中是可操作的。由于在观察实践中没有外周感觉运动系统的特定任务参与，自闭症的模仿困难很可能是由与试验到试验运动执行过程中传出和(重新)传入感觉运动信息的处理有关的感觉运动整合问题所支撑的。

通过模仿模型(例如，老师、家长或照顾者)学习一项技能在许多日常情况下都会发生，例如在教室或家里。对于一些自闭症患者来说，模仿可能很困难，特别是当一项技能是新的或复杂的时候。据说，这些困难是基于自闭症患者观看一项技能，然后为了模仿这项技能而对所观看的内容进行加工。在这项研究中，我们让自闭症患者在一段时间的练习中只看(而不是模仿)一个模型来学习一项新技能。自闭症患者模仿模型的移动方式(动作、时间和风格)，与非自闭症患者相似。这一发现非常重要，因为它表明，人们报告的模仿困难并不是基于自闭症患者观看和处理模型的方式(即他们如何移动)，而是与他们如何计划和准备模仿模型有关的感觉-运动困难的结果。因此，父母/护理人员、临床医生、教师和/或支持人员在通过建模教授新的运动技能和日常技能时，应该考虑自闭症运动障碍。

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A longitudinal study of loneliness in autism and other neurodevelopmental

Hillary Schiltz , Dena Gohari, Jamie Park and Catherine Lord.

Many autistic people and people with non-spectrum neurodevelopmental disabilities (e.g. intellectual disability) report feeling lonely, which can negatively impact their well-being. There is little longitudinal research, however, tracking changes

in how autistic people experience, conceptualize, and cope with loneliness throughout their lives. A longitudinal sample of 114 people, which included autistic participants and participants with neurodevelopmental disabilities, characterized experiences of loneliness, perceptions of other people’s loneliness, and strategies used to cope with loneliness from childhood to adulthood. Level of loneliness and coping strategies were coded from Autism Diagnostic Observation Schedule Modules 3 and 4 protocol forms. Autism Diagnostic Observation Schedule Loneliness Ratings were correlated across time and increased from adolescence to young adulthood. The most common loneliness coping strategies were Behavioral Distraction (e.g. watching TV) and Instrumental Action (e.g. seeking social contact), which were both used by more people in adulthood than childhood. Those who used Behavioral Distraction and a greater number of coping strategies had higher Autism Diagnostic Observation Schedule Loneliness–Self Ratings (i.e. were lonelier) during adolescence and adulthood. Findings highlight adulthood as a particularly vulnerable time for loneliness and indicate a need for more support and social opportunities for autistic adults and adults with neurodevelopmental disabilities who wish to make more social connections.

Lay abstract

We know that many autistic people feel lonely, but we don’t know whether their loneliness changes over time. Our research study followed autistic people and people with other non-spectrum neurodevelopmental disabilities from childhood through young adulthood and asked them about their loneliness. While many people told us they felt lonely or very lonely, a sizable group also told us that they do not feel lonely. We found that people who reported feeling lonely earlier in life were likely to also report feeling lonely later in life. Overall, autistic people and people with other neurodevelopmental disabilities in our study became lonelier from adolescence to adulthood. People described multiple ways they cope with feeling lonely, such as distracting themselves or reaching out to connect with another person. People who used distraction tended to be lonelier than those who did not. Our findings tell us that there is a need for greater support of social connections for many autistic people as they become adults.

摘要  许多自闭症患者和患有非谱系神经发育障碍(如智力障碍)的人报告说感到孤独，这可能会对他们的幸福感产生负面影响。然而，很少有纵向研究跟踪自闭症患者在一生中如何体验、概念化和应对孤独的变化。一项114人的纵向样本，包括自闭症参与者和有神经发育障碍的参与者，描述了孤独的经历，对其他人孤独的感知，以及从童年到成年应对孤独的策略。孤独感水平和应对策略由自闭症诊断观察量表3和4协议表编码。孤独症诊断观察表孤独感评分随时间变化呈正相关，且从青春期到成年期呈递增趋势。最常见的孤独应对策略是行为分心(例如看电视)和工具性行动(例如寻求社交)，这两种策略在成年后使用的人数都多于儿童时期。在青春期和成年期，使用行为分心和较多应对策略的自闭症诊断观察表孤独自评(即更孤独)较高。研究结果突出表明，成年是孤独的特别脆弱的时期，并表明希望建立更多社会关系的自闭症成年人和患有神经发育障碍的成年人需要更多的支持和社交机会。

我们知道许多自闭症患者感到孤独，但我们不知道他们的孤独是否会随着时间的推移而改变。我们的研究跟踪了自闭症患者和患有其他非谱系神经发育障碍的人，从童年到成年，询问他们的孤独感。虽然许多人告诉我们他们感到孤独或非常孤独，但也有相当一部分人告诉我们他们不感到孤独。我们发现，那些在生活早期感到孤独的人很可能在以后的生活中也会感到孤独。总体而言，在我们的研究中，自闭症患者和其他神经发育障碍患者从青春期到成年期变得更加孤独。人们描述了多种应对孤独感的方法，比如分散自己的注意力，或者伸手与另一个人联系。使用分心技术的人往往比不使用分心技术的人更孤独。我们的发现告诉我们，随着许多自闭症患者成年，他们需要更多的社会关系支持。

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Trajectory research in children with an autism diagnosis: A scoping review

Stephen J Gentles, Elise C Ng-Cordell, Michelle C Hunsche，et al.

Researchers increasingly employ longitudinal trajectory methods to understand developmental pathways of people on the autism spectrum across the lifespan. By assessing developmental or health-related outcome domains at three or more timepoints, trajectory studies can characterize their shape and varying rates of change over time. The purpose of this scoping review was to identify and summarize the published breadth of research that uses a trajectory study design to examine development in children (to age 18 years) diagnosed with autism. Using a systematic search and

screening procedure, 103 studies were included. This review summarizes methodological characteristics across studies including the varying statistical approaches used. A series of figures maps where published research is available across

10 outcome domains and the ages over which children have been followed. Evidence gaps, informed by the perspectives of the autistic and caregiver stakeholders that were engaged in this review, are discussed. We recommend that future trajectory research addresses the absence of studies from low- and middle-income countries, considers longitudinal assessment of outcome domains that caregivers and autistic people consider meaningful, and plans follow-up periods with assessment timepoints that cover the gaps in ages where more outcome-specific data are needed.

Lay Abstract

The types of outcomes studied in children on the autism spectrum include clinical characteristics, such as social functioning, communication, language, or autism symptoms. Research that measures these outcomes at multiple timepoints is useful

to improve our understanding of what to expect as children develop. In trajectory studies, researchers assess outcomes at three or more timepoints. This method has advantages over two-timepoint studies because it allows researchers to describe changes in the speed of development, such as accelerations, plateaus, or slowdowns. We identified and reviewed 103 published trajectory studies in children (to age 18 years) with an autism diagnosis. Importantly, we did not include studies of treatments or their effects, nor did we summarize the results of studies. Instead, this review summarizes the characteristics of the available published research, including the methods used, the many different outcomes that have been studied over time and the ages over which they have been studied. This summary may be of interest to autistic people and caregivers (parents) who want to know about the existence of research that provides answers about what to expect during an autistic child’s development. We have recommended that future trajectory research efforts try to make up for the lack of studies from low- and middle-income countries; that more attention is given to the following outcomes that are meaningful to caregivers and autistic people; and to try to fill in the age gaps where more outcome-specific data are needed.

摘要  研究人员越来越多地使用纵向轨迹方法来了解自闭症患者一生中的发展路径。通过评估三个或三个以上时间点的发育或健康相关结果领域，轨迹研究可以表征它们的形状和随时间变化的变化速度。这一范围审查的目的是确定和总结已发表的使用轨迹研究设计来检查被诊断为自闭症的儿童(至18岁)的发展的研究广度。使用系统的搜索和筛选程序，纳入103项研究。这篇综述总结了不同研究的方法学特点，包括使用的不同统计方法。一系列图表描绘了在10个结果领域发表的研究成果以及儿童被跟踪的年龄。证据差距，由自闭症患者和照顾者利益相关者的观点，参与了这一审查，进行了讨论。我们建议，未来的轨迹研究应解决低收入和中等收入国家缺乏研究的问题，考虑对照顾者和自闭症患者认为有意义的结果领域进行纵向评估，并计划具有评估时间点的后续阶段，以弥补需要更多特定结果数据的年龄差距。

自闭症谱系中研究的儿童结果的类型包括临床特征，如社交功能、沟通、语言或自闭症症状。在多个时间点衡量这些结果的研究有助于我们更好地理解儿童发育过程中会发生什么。在轨迹研究中，研究人员在三个或更多的时间点评估结果。这种方法比两个时间点的研究更有优势，因为它允许研究人员描述开发速度的变化，如加速、停滞或减速。我们确定并回顾了103项已发表的关于自闭症儿童(至18岁)的轨迹研究。重要的是，我们没有包括对治疗或其影响的研究，也没有总结研究的结果。相反，这篇综述总结了现有已发表研究的特点，包括所使用的方法，随着时间的推移已经研究的许多不同的结果，以及它们被研究的年代。这一总结可能会引起自闭症患者和照顾者(父母)的兴趣，他们想知道是否有研究为自闭症儿童的发展提供了答案。我们建议，未来的轨迹研究努力努力弥补低收入和中等收入国家研究的不足；更多地关注以下对照顾者和自闭症患者有意义的结果；并努力填补需要更多具体结果数据的年龄差距。

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Motor deficits in autism differ from that of developmental coordination disorder

Marie Martel , Livio Finos, Salam Bahmad，Eric Koun, Romeo Salemme, Sandrine Sonié, Pierre Fourneret, Christina Schmitz7 and Alice Catherine Roy

Autism spectrum disorders and developmental coordination disorders are both associated with sensorimotor impairments, yet their nature and specificity remain unknown. In order to clearly distinguish the specificity between the two disorders, children with autism spectrum disorder or developmental coordination disorder presenting the same degree of motor impairment, thus homogeneous profiles, were examined in a reach-to-displace paradigm, which allows the integrity of two main aspects of motor control (anticipation/feedforward control and movement correction/

feedback control) to be separately interrogated. We manipulated children’s previous knowledge of the weight of the object they were to displace: when known, participants could anticipate the consequences of the weight when reaching for the object, prior to contact with it, thus allowing for feedforward control. Conversely, when unknown prior to contact, participants had to cope with the object weight in the displacing phase of the movement, and use feedback control. Results revealed a preserved feedforward control, but an impaired movement execution (atypical slowness) in children with developmental coordination disorder, while children with autism spectrum disorder displayed the opposite pattern with an impaired feedforward control, but a preserved feedback one. These findings shed light on how specific motor impairments might differently characterize developmental disorders and call for motor rehabilitation programmes adapted to each population.

Lay abstract

A vast majority of individuals with autism spectrum disorder experience impairments in motor skills. Those are often labelled as additional developmental coordination disorder despite the lack of studies comparing both disorders. Consequently, motor skills rehabilitation programmes in autism are often not specific but rather consist in standard programmes for developmental coordination disorder. Here, we compared motor performance in three groups of children: a control group, an autism spectrum disorder group and a developmental coordination disorder group. Despite similar level of motor skills evaluated by the standard movement assessment battery for children, in a Reach-to-Displace Task, children with autism spectrum disorder and developmental coordination disorder showed specific motor control deficits. Children with autism spectrum disorder failed to anticipate the object properties, but could correct their

movement as well as typically developing children. In contrast, children with developmental coordination disorder were atypically slow, but showed a spared anticipation. Our study has important clinical implications as motor skills rehabilitations are crucial to both populations. Specifically, our findings suggest that individuals with autism spectrum disorder would benefit from therapies aiming at improving their anticipation, maybe through the support of their preserved representations and use of sensory information. Conversely, individuals with developmental coordination disorder would benefit from a focus on the use of sensory information in a timely fashion.

摘要  自闭症谱系障碍和发育协调障碍都与感觉运动障碍有关，但其性质和特异性尚不清楚。为了清楚地区分这两种障碍之间的特殊性，对表现出相同程度运动障碍的自闭症谱系障碍或发育协调障碍的儿童进行了伸展到移位范式的检查，该范式允许分别询问运动控制的两个主要方面(预期/前馈控制和运动校正/反馈控制)的完整性。我们操纵了孩子们之前对他们要移动的物体的重量的了解：当知道时，参与者可以在接触物体之前预测到物体重量的后果，从而允许前馈控制。相反，当接触前未知时，参与者必须在移动的移位阶段应对物体重量，并使用反馈控制。结果显示，在发育协调障碍儿童中，前馈控制受到保护，但运动执行受损(非典型缓慢)，而自闭症谱系障碍儿童表现出相反的模式，前馈控制受损，但反馈受到保护。这些发现阐明了具体的运动障碍可能如何不同地表现出发育障碍的特征，并呼吁根据每个人口的情况制定运动康复方案。

自闭症谱系障碍的绝大多数人都有运动技能障碍的经历。尽管缺乏对这两种疾病进行比较的研究，但这些疾病通常被贴上额外的发育协调障碍的标签。因此，自闭症的运动技能康复方案往往不是具体的，而是包含在针对发育协调障碍的标准方案中。在这里，我们比较了三组儿童的运动表现：对照组，自闭症谱系障碍组和发育协调障碍组。尽管儿童标准运动评估组合评估的运动技能水平相似，但在伸展到移动任务中，患有自闭症谱系障碍和发展协调障碍的儿童表现出特定的运动控制缺陷。患有自闭症谱系障碍的儿童无法预测物体的特性，但可以纠正他们的动作，就像典型的发育儿童一样。相比之下，患有发育协调障碍的儿童表现得异常迟缓，但表现出较少的预期。我们的研究具有重要的临床意义，因为运动技能康复对这两个群体都至关重要。具体地说，我们的发现表明，自闭症谱系障碍患者将受益于旨在改善他们预期的治疗，可能是通过支持他们保留的表征和使用感觉信息。相反，患有发育协调障碍的人将受益于对及时使用感觉信息的关注。

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补充缺失的声音：自闭症青年对执行功能评定量表的自我报告与父母报告以及注意缺陷多动障碍或神经典型发育青年的自我报告的比较

Lauren Kenworthy , Alyssa Verbalis, Julia Bascom, Sharon daVanport, John F Strang, Cara Pugliese, Andrew Freeman, Charlotte Jeppsen, Anna C Armour, Geneva Jost, Kristina Hardy and Gregory L Wallace

Executive functions are related to key outcomes. Studies of autistic youth self-report of other nonsocial traits indicate that their insights into their own functioning and internal experiences provide important information that is not captured by their parents’ report, but youth self-report of executive function has not been researched in autism. We investigate self- and parent-report on the Behavior Rating Inventory of Executive Function-2 in 197 autistic youth without intellectual disability, including the magnitude and profile of problems reported across subdomains of executive function. We also compare autistic self-report to that of 114 youth with attention deficit hyperactivity disorder and 197 neurotypical youth. We find that autistic youth report significant executive function challenges in comparison to neurotypical youth and a distinctive profile of challenges in comparison to attention deficit hyperactivity disorder youth. Parents and their autistic children diverge regarding the severity of the youth’s executive function difficulties, but both emphasize flexibility problems within their profile of executive function challenges. Intraclass correlation coefficients between parent and youth ratings were moderate to poor in the autistic group, indicating that autistic youth report adds important information beyond that captured by their parents’ report. These data elevate the importance of asking autistic youth directly about their own executive function.

执行功能与关键结果有关。对自闭症青年自我报告的其他非社会特征的研究表明，他们对自身功能和内在经验的洞察提供了父母报告所没有的重要信息，但自闭症青年对执行功能的自我报告尚未得到研究。我们调查了197名没有智力残疾的自闭症青年在《执行功能行为评定量表》中的自我报告和父母报告，包括执行功能子领域报告的问题的严重程度和概况。我们还比较了自闭症青年、114名注意力缺陷多动障碍青年和197名神经典型青年的自我报告。我们发现，与神经典型青年相比，自闭症青年报告了显著的执行功能挑战，与注意力缺陷多动障碍青年相比，自闭症青年的挑战具有独特的特点。父母和他们的自闭症儿童在青年的执行功能困难的严重程度方面存在分歧，但都强调了他们在执行功能挑战概况中的灵活性问题。在自闭症组中，父母和青年的评分之间的内部相关系数为中度至低度，表明自闭症青年的报告增加了父母报告所没有的重要信息。这些数据提高了直接询问自闭症青年自身执行功能的重要性。

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心理优势和幸福感：优势利用可预测自闭症患者的生活质量、幸福感和心理健康

Emily C Taylor , Lucy A Livingston, Rachel A Clutterbuck, Mitchell J Callan and Punit Shah

Strengths-based approaches to autism are increasing in research and clinical practice. Such approaches suggest facilitating autistic people to increase the use of their strengths leads to positive outcomes (e.g. improved well-being). However, despite proliferation of strengths-based clinical and educational interventions, these approaches are grounded on several assumptions that remain uninvestigated. Little is known about the specific strengths of autistic people, nor their current knowledge and use of their strengths. Critically, no research has directly tested if autistic people’s strengths knowledge and use is in fact associated with positive outcomes. Conducting an exploratory study, including the first well-powered comparisons of the self-reported strengths, strengths knowledge, and strengths use of matched autistic and non-autistic samples (N=276), we found that autistic and non-autistic participants reported similar strengths. While autistic people reported lower strengths knowledge and use, strengths use in autism strongly predicted better quality of life, subjective well-being, and lower levels of anxiety, depression, and stress. Thus, strength-based approaches and clinical interventions designed to increase strengths use may pose a valuable method for boosting well-being in autism. However, we suggest such approaches should focus on individuals’ strengths more generally, rather than perceived autism-specific abilities.

基于优势的自闭症治疗方法在研究和临床实践中越来越多。这种方法建议促进自闭症患者更多地利用他们的优势，从而带来积极的结果（例如改善幸福感）。然而，尽管基于优势的临床和教育干预措施激增，但这些方法都是基于几个尚未得到研究的假设。关于自闭症患者的具体优势，以及他们目前的知识和优势使用情况，我们知之甚少。至关重要的是，没有研究直接测试自闭症患者的优势知识和使用是否确实与积极的结果相关。进行探索性研究，包括首次对自报优势、优势知识和优势使用进行匹配的自闭症和非自闭症样本（N=276）的有效比较，我们发现自闭症和非自闭症参与者报告了相似的优势。虽然自闭症患者报告的优势知识和使用较低，但自闭症的优势使用强烈预示着更好的生活质量、主观幸福感和较低的焦虑、抑郁和压力水平。因此，旨在增加优势使用的基于优势的方法和临床干预可能是提高自闭症患者幸福感的有价值的方法。然而，我们建议这些方法应该更广泛地关注个人的优势，而不是感知到的自闭症特异性能力。

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社交媒体塑造自闭症感知和身份

Ingjerd Skafle , Elia Gabarron and Anders Nordahl-Hansen

The aim of this study was to explore how autistic adults experienced using social media to find information about autism, and how they experienced online autistic communities. There is little research on the rationale why autistic people look for information on autism via social media, and on how such information is perceived from an autistic viewpoint. Twelve Norwegian autistic adults (aged 18–49 years) completed semi-structured interviews where they discussed social media and content specifically about autism and online autistic communities. Using reflexive thematic analysis, three main themes were developed. The themes were (1) Representation and Identity: An Online Journey; (2) An Unreliable, but Necessary Tool; and (3) Tensions and Discord. The findings indicated that even though social media was looked upon as an unreliable information source, the participants found information that helped them to learn about their experiences which had not been fully captured by the majority of the current research literature and online health sites. Also, social media groups for autistic people did not necessarily create a sense of community, as participants reported feeling alienated by hostile discussions. This study highlights the importance of having a greater variation and availability of information about autism online through official health channels.

本研究旨在探索自闭症成年人如何使用社交媒体查找有关自闭症的信息，以及他们如何体验在线自闭症社区。关于自闭症患者通过社交媒体查找有关自闭症的信息的原理，以及如何从自闭症患者的角度看待这些信息的研究很少。12名挪威自闭症成年人（18-49岁）完成了半结构化访谈，他们讨论了社交媒体和关于自闭症和在线自闭症社区的内容。使用反思性主题分析，提出了三个主要主题。主题是（1）代表性和身份：在线旅程；（2）不可靠但必要的工具；和（3）紧张和不和谐。研究结果表明，尽管社交媒体被视为不可靠的信息来源，但参与者发现了帮助他们了解其经历的信息，而这些信息尚未被当前大多数研究文献和在线健康网站充分捕捉到。此外，自闭症患者的社交媒体团体不一定能创造社区感，因为参与者报告说他们被敌对讨论疏远了。本研究强调了通过官方健康渠道在网上获取更多有关自闭症的信息的重要性。

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学校中自闭症学生的融入：德国教师的知识、自我效能和态度

Jörg Wittwer , Sandra Hans and Thamar Voss

To provide inclusive education to autistic students, it is important that teachers possess knowledge about autism, feel competent in teaching autistic students, and have a positive attitude toward the inclusion of autistic students. In this study, we explored knowledge, self-efficacy, and attitude concerning autism among N=887 teachers in Germany. The results showed that knowledge about autism was only moderate and teachers held some typical misconceptions about autism. Moreover, teachers did not possess overwhelmingly high self-efficacy beliefs whereas their attitude toward inclusion of autistic students was rather positive. Experience with teaching autistic students was associated with more knowledge and higher self-efficacy. Also, female teachers were more knowledgeable about autism and felt more competent in teaching autistic students than male teachers. However, the type of school where teachers were working made hardly any difference in their knowledge, self-efficacy, and attitude. Overall, the results suggest that teachers in Germany need more autism training to increase their knowledge about autism and their self-efficacy beliefs in teaching autistic students

为了给自闭症学生提供融合性教育，教师必须具备关于自闭症的知识，能够胜任自闭症学生的教学，并对包容自闭症学生持积极态度。在这项研究中，我们探索了德国887名教师对自闭症的知识、自我效能和态度。结果表明，对自闭症的知识仅是中等程度的，教师对自闭症有一些典型的误解。此外，教师并没有很高的自我效能信念，他们对包容自闭症学生的态度是相当积极的。有自闭症学生教学经验的人拥有更多的知识和更高的自我效能。此外，女教师比男教师更了解自闭症，并且对自闭症学生的教学更有能力。然而，教师工作的学校类型在他们的知识、自我效能和态度上几乎没有差别。总体而言，结果表明德国的教师需要更多的自闭症培训，以增加他们对自闭症的知识和他们在自闭症学生教学中的自我效能信念。

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自闭症和非自闭症儿童自闭症特征与家庭功能随时间的变化之间的关系

Leontine W ten Hoopen , Pieter FA de Nijs, Geerte Slappendel Jan van der Ende, Dennis Bastiaansen, Kirstin Greaves-Lord, Leona Hakkaart-van Roijen and Manon HJ Hillegers

To explore associations between autism traits and family functioning over time, we studied longitudinal data of a mixed group of 168 clinically referred autistic and non-autistic children. Cross-lagged models showed a significant association between fewer autism traits at the diagnostic assessment and better family functioning 1year later for the whole group, independently of children’s internalizing or externalizing behavior. When splitting the group into autistic children (58%) and non-autistic children (42%) based on an autism diagnosis, this association was only significant in the subgroup of non-autistic children with autism traits. We hypothesized that the needs of families experiencing difficulty understanding and adjusting to their children with autism traits, but no clinical autism diagnosis, might be unmet without the training or support facilities offered to families with autistic children. Although further research is needed to explore this association, clinicians may also consider supporting families of non-autistic children with autism traits to prevent family functioning problems. Because high autism trait levels in non-autistic children may be of a different origin than autism, for example, other neurodevelopmental or mental health problems, family training or support should be tailored to the child’s underlying difficulties

为了探索自闭症特征与家庭功能随时间的变化之间的关系，我们研究了168名临床转诊的自闭症和非自闭症儿童的混合群体的纵向数据。跨时滞模型显示，整个群体在诊断评估时自闭症特征较少，而1年后家庭功能较好，这与儿童的内化或外化行为无关。当根据自闭症诊断将群体分为自闭症儿童（58%）和非自闭症儿童（42%）时，这种关联仅在具有自闭症特征的非自闭症儿童亚群中显著。我们假设，如果不对患有自闭症儿童的家庭提供培训或支持设施，那么那些难以理解和适应患有自闭症特征但未被临床诊断为自闭症的儿童的需求可能无法得到满足。虽然需要进一步的研究来探索这种关联，但临床医生也可以考虑支持患有自闭症特征的非自闭症儿童的家庭，以防止家庭功能问题。由于非自闭症儿童的高自闭症特征水平可能与自闭症不同，例如其他神经发育或心理健康问题，因此应根据儿童的潜在困难量身定制家庭培训或支持。

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