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Research paper thumbnail of Behavior problems among school-aged children with autism spectrum disorder: Associations with children's communication difficulties and parenting behaviors

Research in Autism Spectrum Disorders, 2014

Research has clearly demonstrated that behavior problems are common among children with ASD. Thes... more Research has clearly demonstrated that behavior problems are common among children with ASD. These co-occurring behavior problems place children with ASD and their families at risk for a range of negative outcomes. This questionnaire study aimed to investigate whether and how age, gender, and communication difficulties at the child level and parenting behaviors at the family level are associated with externalizing and internalizing problems among children with ASD (nn = 206) and without ASD (n = 187) aged 6-n = 187) aged 6-12 years. Results indicated that pragmatic language difficulties of the child and negative controlling parenting behaviors both made a significant and unique contribution to externalizing behavior problems for the ASD group. In the control group, chronological age and pragmatic language difficulties were the most robust concurrent predictors of externalizing problems. With regard to internalizing problems, pragmatic language difficulties and ASD adapted parenting behaviors were significant predictors for both the ASD and control group.

Research paper thumbnail of Young children with language difficulties: A dimensional approach to subgrouping

Research in Developmental Disabilities, 2013

A dimensional approach was used to create bottom-up constructed subgroups that captured the behav... more A dimensional approach was used to create bottom-up constructed subgroups that captured the behavioral heterogeneity in 36 Dutch-speaking children with language difficulties. Four subgroups were delineated based upon differences in cognitive ability, symbol understanding, joint attention and autism spectrum disorder related characteristics. Children with a different developmental disorder were found within a single cluster. Therefore, the results of this study suggest that bottom-up constructed subgroups might capture the heterogeneous behavioral profiles of young children with developmental difficulties in a more meaningful way. Furthermore, joint attention and symbol understanding seem important skills to assess in young children presenting with language difficulties.

Research paper thumbnail of Level of sense-making in children with autistic disorder and intellectual disability: Patterns of delay and deviance in development

Research in Autism Spectrum Disorders, 2012

The present study examined levels of sense-making in relation to adaptive functioning and autism ... more The present study examined levels of sense-making in relation to adaptive functioning and autism symptomatology in low-functioning children with autistic disorder. Thirty-six children with autistic disorder and intellectual disability were compared with 27 children with intellectual disability and 33 typically developing children with a comparable nonverbal mental age (2-5 years). Level of sense-making was measured with the ComFor. Delays and deviant behaviors were assessed by using the Vineland Screener 0-6-NL and the Diagnostic Interview for Social and Communication Disorders. Levels of sense-making were substantially lower in the group with autistic disorder. At non-symbolic levels of sense-making, children with autistic disorder and intellectual disability were much lower functioning in terms of social and communicative adaptive behavior than the children in the comparison groups with the same level of sensemaking. Within the autism group, lower levels of sense-making were associated with more severe autism symptomatology in the domains of social interaction, communication, and imagination.

Research paper thumbnail of Intentional communication in nonverbal and verbal low-functioning children with autism

Journal of Communication Disorders, 2011

In this study we characterized profiles of communicative functions and forms of children with aut... more In this study we characterized profiles of communicative functions and forms of children with autism and intellectual disability (n = 26), as compared to typically developing children (n = 26) with a comparable nonverbal mental age (2 -5 years). Videotapes of the Communication and Symbolic Behavior Scales -Developmental Profile were analyzed using a standardized observation scheme in which three main functions were distinguished: behavior regulation, social interaction, and joint attention. Different forms of communication were also investigated: gestures, vocalizations / verbalizations, and eye gaze. Results indicated that in typically developing children the proportion of communication for the purpose of joint attention was much higher than for behavior regulation, whereas in children with autism the opposite pattern was seen. Low-functioning nonverbal children with autism mainly communicated for behavior regulation and not or only rarely for declarative purposes. Generally, this subgroup used the least complex forms to communicate. Low-functioning verbal children with autism differed from typically developing children only in the rate, not in the proportion of communication for specific functions. Combinations of three different communicative forms were used by verbal children with autism less frequently than by typically developing children.

Research paper thumbnail of Language in Low-Functioning Children with Autistic Disorder: Differences Between Receptive and Expressive Skills and Concurrent Predictors of Language

Journal of Autism and Developmental Disorders, 2012

Research paper thumbnail of Evaluation of the criterion and convergent validity of the Diagnostic Interview for Social and Communication Disorders in young and low-functioning children

Autism, 2012

The Diagnostic Interview for Social and Communication Disorders (DISCO;) is a standardized, semi-... more The Diagnostic Interview for Social and Communication Disorders (DISCO;) is a standardized, semi-structured and interviewer-based schedule for diagnosis of autism spectrum disorder (ASD). The objective of this study was to evaluate the criterion and convergent validity of the DISCO-11 ICD-10 algorithm in young and low-functioning children. The DISCO-11, Autism Diagnostic Observation Schedule (ADOS), and Social Communication Questionnaire (SCQ) were administered to a Dutch sample of 115 children comprising 52 children with ASD (both with and without intellectual disability), 26 children with intellectual disability (non-ASD), and 37 typically developing children. Results indicated high sensitivity and specificity for DISCO-11 classifications in differentiating ASD from non-ASD according to the clinical classification in children with mild intellectual disability or average intelligence. Among children with a moderate or severe intellectual disability the sensitivity was equally high, but the specificity was significantly lower. The agreement between DISCO-11 and ADOS classifications was substantial, between DISCO-11 and SCQ moderate. The correlations between raw scores of the DISCO and ADOS algorithm or SCQ were both high. In conclusion, the DISCO-11 differentiates accurately between autistic disorder and non-ASD in young children with an average intelligence or mild intellectual disability, but is over inclusive in the lower levels of intellectual disability. autism spectrum disorder, diagnostic interview, validity

Research paper thumbnail of Maternal Parenting Behavior and Child Behavior Problems in Families of Children and Adolescents with Autism Spectrum Disorder

Journal of Autism and Developmental Disorders, 2014

Parents of a child with autism spectrum disorder (ASD) face specific challenges in parenting, but... more Parents of a child with autism spectrum disorder (ASD) face specific challenges in parenting, but concrete parenting behavior has never been properly investigated in these families. This exploratory questionnaire study compared parenting behaviors among mothers of children and adolescents with ASD (n = 552) and without ASD (n = 437) and examined associations between child behavior problems and parenting behavior. Results showed that mothers of children with ASD reported significantly lower scores on Rules and Discipline and higher scores on Positive Parenting, Stimulating the Development, and Adapting the Environment. Age was differently related to parenting behavior in the ASD versus control group. Furthermore, distinctive correlation patterns between parenting behavior and externalizing or internalizing behavior problems were found for both groups.

Research paper thumbnail of Behavior problems among school-aged children with autism spectrum disorder: Associations with children's communication difficulties and parenting behaviors

Research in Autism Spectrum Disorders, 2014

Research has clearly demonstrated that behavior problems are common among children with ASD. Thes... more Research has clearly demonstrated that behavior problems are common among children with ASD. These co-occurring behavior problems place children with ASD and their families at risk for a range of negative outcomes. This questionnaire study aimed to investigate whether and how age, gender, and communication difficulties at the child level and parenting behaviors at the family level are associated with externalizing and internalizing problems among children with ASD (nn = 206) and without ASD (n = 187) aged 6-n = 187) aged 6-12 years. Results indicated that pragmatic language difficulties of the child and negative controlling parenting behaviors both made a significant and unique contribution to externalizing behavior problems for the ASD group. In the control group, chronological age and pragmatic language difficulties were the most robust concurrent predictors of externalizing problems. With regard to internalizing problems, pragmatic language difficulties and ASD adapted parenting behaviors were significant predictors for both the ASD and control group.

Research paper thumbnail of Young children with language difficulties: A dimensional approach to subgrouping

Research in Developmental Disabilities, 2013

A dimensional approach was used to create bottom-up constructed subgroups that captured the behav... more A dimensional approach was used to create bottom-up constructed subgroups that captured the behavioral heterogeneity in 36 Dutch-speaking children with language difficulties. Four subgroups were delineated based upon differences in cognitive ability, symbol understanding, joint attention and autism spectrum disorder related characteristics. Children with a different developmental disorder were found within a single cluster. Therefore, the results of this study suggest that bottom-up constructed subgroups might capture the heterogeneous behavioral profiles of young children with developmental difficulties in a more meaningful way. Furthermore, joint attention and symbol understanding seem important skills to assess in young children presenting with language difficulties.

Research paper thumbnail of Level of sense-making in children with autistic disorder and intellectual disability: Patterns of delay and deviance in development

Research in Autism Spectrum Disorders, 2012

The present study examined levels of sense-making in relation to adaptive functioning and autism ... more The present study examined levels of sense-making in relation to adaptive functioning and autism symptomatology in low-functioning children with autistic disorder. Thirty-six children with autistic disorder and intellectual disability were compared with 27 children with intellectual disability and 33 typically developing children with a comparable nonverbal mental age (2-5 years). Level of sense-making was measured with the ComFor. Delays and deviant behaviors were assessed by using the Vineland Screener 0-6-NL and the Diagnostic Interview for Social and Communication Disorders. Levels of sense-making were substantially lower in the group with autistic disorder. At non-symbolic levels of sense-making, children with autistic disorder and intellectual disability were much lower functioning in terms of social and communicative adaptive behavior than the children in the comparison groups with the same level of sensemaking. Within the autism group, lower levels of sense-making were associated with more severe autism symptomatology in the domains of social interaction, communication, and imagination.

Research paper thumbnail of Intentional communication in nonverbal and verbal low-functioning children with autism

Journal of Communication Disorders, 2011

In this study we characterized profiles of communicative functions and forms of children with aut... more In this study we characterized profiles of communicative functions and forms of children with autism and intellectual disability (n = 26), as compared to typically developing children (n = 26) with a comparable nonverbal mental age (2 -5 years). Videotapes of the Communication and Symbolic Behavior Scales -Developmental Profile were analyzed using a standardized observation scheme in which three main functions were distinguished: behavior regulation, social interaction, and joint attention. Different forms of communication were also investigated: gestures, vocalizations / verbalizations, and eye gaze. Results indicated that in typically developing children the proportion of communication for the purpose of joint attention was much higher than for behavior regulation, whereas in children with autism the opposite pattern was seen. Low-functioning nonverbal children with autism mainly communicated for behavior regulation and not or only rarely for declarative purposes. Generally, this subgroup used the least complex forms to communicate. Low-functioning verbal children with autism differed from typically developing children only in the rate, not in the proportion of communication for specific functions. Combinations of three different communicative forms were used by verbal children with autism less frequently than by typically developing children.

Research paper thumbnail of Language in Low-Functioning Children with Autistic Disorder: Differences Between Receptive and Expressive Skills and Concurrent Predictors of Language

Journal of Autism and Developmental Disorders, 2012

Research paper thumbnail of Evaluation of the criterion and convergent validity of the Diagnostic Interview for Social and Communication Disorders in young and low-functioning children

Autism, 2012

The Diagnostic Interview for Social and Communication Disorders (DISCO;) is a standardized, semi-... more The Diagnostic Interview for Social and Communication Disorders (DISCO;) is a standardized, semi-structured and interviewer-based schedule for diagnosis of autism spectrum disorder (ASD). The objective of this study was to evaluate the criterion and convergent validity of the DISCO-11 ICD-10 algorithm in young and low-functioning children. The DISCO-11, Autism Diagnostic Observation Schedule (ADOS), and Social Communication Questionnaire (SCQ) were administered to a Dutch sample of 115 children comprising 52 children with ASD (both with and without intellectual disability), 26 children with intellectual disability (non-ASD), and 37 typically developing children. Results indicated high sensitivity and specificity for DISCO-11 classifications in differentiating ASD from non-ASD according to the clinical classification in children with mild intellectual disability or average intelligence. Among children with a moderate or severe intellectual disability the sensitivity was equally high, but the specificity was significantly lower. The agreement between DISCO-11 and ADOS classifications was substantial, between DISCO-11 and SCQ moderate. The correlations between raw scores of the DISCO and ADOS algorithm or SCQ were both high. In conclusion, the DISCO-11 differentiates accurately between autistic disorder and non-ASD in young children with an average intelligence or mild intellectual disability, but is over inclusive in the lower levels of intellectual disability. autism spectrum disorder, diagnostic interview, validity

Research paper thumbnail of Maternal Parenting Behavior and Child Behavior Problems in Families of Children and Adolescents with Autism Spectrum Disorder

Journal of Autism and Developmental Disorders, 2014

Parents of a child with autism spectrum disorder (ASD) face specific challenges in parenting, but... more Parents of a child with autism spectrum disorder (ASD) face specific challenges in parenting, but concrete parenting behavior has never been properly investigated in these families. This exploratory questionnaire study compared parenting behaviors among mothers of children and adolescents with ASD (n = 552) and without ASD (n = 437) and examined associations between child behavior problems and parenting behavior. Results showed that mothers of children with ASD reported significantly lower scores on Rules and Discipline and higher scores on Positive Parenting, Stimulating the Development, and Adapting the Environment. Age was differently related to parenting behavior in the ASD versus control group. Furthermore, distinctive correlation patterns between parenting behavior and externalizing or internalizing behavior problems were found for both groups.