Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder without a known cure. Current standard-of-care treatments focus on addressing core symptoms directly but have provided limited benefits. In many cases, individuals with ASD have abnormalities in multiple organs, including the brain, immune and gastrointestinal system, and multiple physiological systems including redox and metabolic systems. Additionally, multiple aspects of the environment can adversely affect children with ASD including the sensory environment, psychosocial stress, dietary limitations and exposures to allergens and toxicants. Although it is not clear whether these medical abnormalities and environmental factors are related to the etiology of ASD, there is evidence that many of these factors can modulate ASD symptoms, making them a potential treatment target for improving core and associated ASD-related symptoms and improving functional limitation. Additionally, addressing underlying biological disturbances that drive pathophysiology has the potential to be disease modifying. This article describes a systematic approach using clinical history and biomarkers to personalize medical treatment for children with ASD. This approach is medically comprehensive, making it attractive for a multidisciplinary approach. By concentrating on treatable conditions in ASD, it is possible to improve functional ability and quality of life, thus providing optimal outcomes.

https://www.mdpi.com/2075-4426/12/3/464/pdf?version=1647254321

A Personalized Multidisciplinary Approach to Evaluating and Treating Autism Spectrum Disorder

Research shows high rates of anxious symptoms in people autistic spectrum disorder (ASD). Finding factors related to the development of anxiety in ASD is necessary. Emotion regulation (ER) is associated with anxiety in ASD. Moreover, some studies find higher rates of anxiety in women with ASD. A total of 121 adults (M = 35.46 years, SD = 9.46) with ASD and intellectual disabilities were evaluated to verify moderating role of gender and mediating role of ER. A moderated mediation analysis supported the moderated role of gender in the relationship mediated by emotional dysregulation between ASD and anxiety. These findings suggest that interventions designed to prevent or reduce anxiety symptoms in women with ASD should include among their goals emotional regulation.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/aur.2839

Does the gender matter?: Anxiety symptoms and emotion dysregulation in adults with autism and intellectual disabilities

The majority of autistic toddlers present with clinically significant levels of internalizing or externalizing behaviors. Despite the prevalence of internalizing and externalizing behaviors in caseloads, the overwhelming majority of speech-language pathologists (SLPs) have not received specialized instruction in how to support children with these behaviors. The purpose of this study was to identify which child and caregiver characteristics are most associated with internalizing and externalizing behaviors in autistic toddlers in order to consider how SLPs may tailor their treatment to better support the individual needs of autistic children.Participants included 109 mothers and their autistic children between 18 and 48 months of age. This study was a secondary analysis of data from a randomized clinical trial. Participants' baseline data included a variety of child (i.e., expressive language, receptive language, restricted and repetitive behavior [RRB], and nonverbal cognition) and caregiver (i.e., self-efficacy and responsiveness) characteristics. Seemingly unrelated regressions were conducted to determine which characteristics were associated with internalizing and externalizing behaviors in autistic toddlers.Higher RRB scores were associated with both higher internalizing and externalizing behavior scores. A lower nonverbal cognition score was also associated with higher internalizing behavior scores but to a lesser extent than RRB.These findings suggest that SLPs may support internalizing and externalizing behaviors in autistic children by taking RRBs and nonverbal cognition into consideration. 

Understanding Internalizing and Externalizing Behaviors in Autistic Toddlers

ABSTRACT Many research studies have shown a prevalence of comorbid depressive symptomatology in people with an autism spectrum disorder. This prevalence is much higher than the rates in the normotypic population. The purpose of this study is to clarify the factors that moderate the association between depression and autism. One hundred and twenty-one adults (M = 35.46 years¸ SD = 9.46) with ASD and an intellectual disability participated in this study. The results showed that sex and age significantly moderate the relationship between ASD and depressive symptoms. Specifically, males aged between 30 and 49 were the most vulnerable group for the development of depressive symptoms. These results suggest that interventions designed to prevent or reduce depressive symptoms in people with ASD should consider that males aged 30–49 are more vulnerable than the rest of the population to suffering from a depressive disorder.

Gender and age as moderators of depressive symptoms in people with ASD and ID (El género y la edad como moderadores de los síntomas depresivos en personas con TEA y DI)

Symptoms of internalized psychopathologies, such as anxiety and depression, are common in people with Autism Spectrum Disorder (ASD). Their presence is a difficulty because it prohibits inclusion and quality of life of this population. Despite ongoing research, there is still a gap in understanding these issues, particularly when it comes to adults with intellectual disabilities. Much of the existing research has primarily focused on studying comorbid conditions in children with ASD, often those who are high-functioning, leaving crucial segments of the autistic spectrum unexplored. Recent literature indicates that variables like executive functioning, emotional regulation, and intolerance to uncertainty are crucial in explaining the connection between internalized symptoms and ASD. These variables appear to contribute to the development and persistence of internalized psychopathologies in individuals with ASD. Yet, many aspects of this association, including the expression of these symptoms and their treatment, remain uncertain. Studying this aspect is vital for promoting prevention, early diagnosis, and a deeper understanding of these symptoms within the autism population. Nevertheless, it contains certain complexity as a result of the characteristics of ASD, associated intellectual disability, language difficulties, or phenotypic overlap between some comorbid psychopathologies and autism. All these difficulties mean that this field is under-researched, causing serious mental health and quality of life problems for people on the autistic spectrum, family members, carers, therapists, etc. This chapter reviews the scientific literature on comorbidity in autism, specifically on anxious and depressive symptoms. The aim is to update the findings reached by the research on comorbidity, prevalence, and expression of these symptoms in adults on the autism spectrum. 

Mood Alternations on the Autistic Spectrum

BACKGROUND The behavioral characteristics of children with autism spectrum disorder (ASD) are not only affected by their disease, but also by their parenting environment. HR-ASD has the risk of developing internalization and externalization problems. How the early development of these behavioral problems is affected by parent-child interaction is worth exploring. We tested whether parent-child interactions and parenting characteristics were associated with behavioural problems during the infant periods. METHODS This study collected data from 91 infants at high risk for ASD and 68 matched typically developing (TD) infants, about their internalizing and externalizing behavioural problems and engagement states (i.e. positive, negative, and parent-child interactions), using free play paradigm. Parent measures were assessed using the Broad Autism Phenotypic Questionnaire (BAPQ) and Parenting Stress Index Short Form (PSI-SF) questionnaire. The core symptoms of ASD were assessed using the the Autism Diagnostic Observational Schedule (ADOS). RESULTS During free play, infants in the HR-ASD group showed more internalizing (P < 0.001) and externalizing (P < 0.05) behaviours and less positive engagement (P < 0.01) than the TD group. In the regression analysis, we found that parenting stress had an impact on the infants' externalizing behaviours (△R2 = 0.215). Parent negative engagement had an impact on the infants' internalizing behaviours (△R2 = 0.451). CONCLUSIONS The present study revealed that children at high risk for ASD exhibited more severe internalizing and externalizing behavioural problems than TD group. The parent negative engagement is associated with behavioural problems. The findings on the contribution of parents' factors to behavioural problems suggests that the parenting stress and parent-child interactions are important factors for mitigating behavioural problems.

/pdf/the-characteristics-and-factors-of-the-internalizing-and-26yteyrhle.pdf

The characteristics and factors of the internalizing and externalizing behaviours of children at high risk for autism spectrum disorder.

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The characteristics and factors of the internalizing and externalizing behaviours of children at high risk for autism spectrum disorder.