COVID-19 brought disruptions to children’s education and mental health, and accelerated school de-registration rates. We investigated Elective Home Education (EHE) in families of children with a... Show moreCOVID-19 brought disruptions to children’s education and mental health, and accelerated school de-registration rates. We investigated Elective Home Education (EHE) in families of children with a neurodevelopmental condition. A total of 158 parents of 5–15 year-old children with neurodevelopmental conditions (80% autistic) provided information on reasons for de-registration, their experience of EHE, and children’s mental health. Few differences were found between children participating in EHE before and after the pandemic started. Low satisfaction with school for not meeting children’s additional needs was the main reason for deregistering in both groups. COVID-19 had a more limited role in parents’ decision to de-register. The main advantage of EHE reported in both groups was the provision of personalised education and one-to-one support. Levels of anxiety, internalising and externalising problems were similar between children participating in EHE before and after the pandemic started, and also similar between all children in EHE and school-registered children (N = 1,079). Show less
This thesis investigated the development of emotional functioning in 2-to-6-year-old children with and without autism. Whereas autistic children experienced more challenges in the emotional domain,... Show moreThis thesis investigated the development of emotional functioning in 2-to-6-year-old children with and without autism. Whereas autistic children experienced more challenges in the emotional domain, their emotional abilities improved with age, and developed in similar ways as observed in non-autistic children. On the one hand, this thesis showed that autistic children might deal with emotions in a different way, and they might experience various difficulties when communicating emotions with non-autistic people. One the other hand, it is important to note that the difficulties could be bidirectional. As stated by the “double empathy problem”, non-autistic people may experience the same difficulties when communicating with autistic people. This could be a meaningful direction for future research, investigating emotional communication as a two-way interaction rather than focusing only on how people with autism react to people without autism. Furthermore, this thesis showed that autistic children had the potential to learn and to develop in the emotional domain. Again, this points to the importance of investigating how to create an inclusive social environment, which is not only nurturing for children without autism, but can also benefit the development of children with autism and with other special needs. Show less
Hof, M.V. van 't; Ester, W.A.; Serdarevic, F.; Berckelaer-Onnes, I. van; Hillegers, M.H.J.; Tiemeier, H.; ... ; Jansen, P.W. 2020
Children with Autism Spectrum Disorder (ASD) often exhibit problematic eating behaviors, an observation mostly based on male dominated, clinical ASD study samples. It is, however, important to... Show moreChildren with Autism Spectrum Disorder (ASD) often exhibit problematic eating behaviors, an observation mostly based on male dominated, clinical ASD study samples. It is, however, important to evaluate both children with an ASD diagnosis and children with subclinical autistic traits as both often experience difficulties. Moreover, considering the suggestion of a possible girl-specific ASD phenotype, there is a need to determine whether autistic traits are related with problematic eating behaviors in girls as well. This study explores the sex-specific association between autism (both autistic traits and diagnosed ASD) and eating behavior in middle childhood in Generation R, a prospective population-based cohort from fetal life onwards. We collected parental reports of autistic traits at six years (Social Responsiveness Scale) and of eating behavior at ten years (Children's Eating Behaviour Questionnaire). In this cohort of 3559 children, autistic traits at six years were associated with more Picky Eating, Emotional Eating and Food Responsiveness in later childhood (e.g. adjusted B for Picky Eating = 0.07; 95% CI: 0.03, 0.11). Stratified analyses showed that in girls, autistic traits were associated with more Emotional Overeating and Emotional Undereating (e.g. adjusted B for Emotional Undereating= 0.12; 95% CI: 0.04, 0.20), while no associations were found for boys. Results comparing children with and without an ASD diagnosis in the cohort largely confirm these associations (e.g. in girls, adjusted B for Emotional Undereating = 0.72; 95% CI: 0.01, 1.42). Our results point to a sex-specific association between autism and eating behavior in middle childhood. Also, our study is the first study to show that autistic traits are associated with emotionally based eating problems in girls and possibly represent part of a girl-specific ASD phenotype. Show less
van't Hof, M.; Berckelaer-Onnes, I. van; Deen, M.; Neukerk, M.C.; Bannink, R.; Daniels, A.M.; ... ; Ester, W.A. 2020
Professionals' limited knowledge on mental health and their stigmatizing attitudes toward mental illness can delay the diagnosis of autism. We evaluated the knowledge on Autism Spectrum Disorder ... Show moreProfessionals' limited knowledge on mental health and their stigmatizing attitudes toward mental illness can delay the diagnosis of autism. We evaluated the knowledge on Autism Spectrum Disorder (ASD) and stigmatizing attitudes in 93 physicians at Dutch Youth and Family Centers (YFC). These physicians screen for psychiatric symptoms in children. We show that their general ASD knowledge scored 7.1 (SD 1.2), but their specific ASD knowledge was only 5.7 (SD 1.7) (weighted means on 1-10 scale, 1 = least knowledge, 10 = most knowledge). Our physicians had positive attitudes toward mental illness (CAMI scores 2.18 (SD 0.33) to 2.22 (SD 0.40) on a 5-point Likert scale) but they had higher levels of stigmatizing attitudes than other Western healthcare professionals. Their levels were considerably lower than in non-Western professionals. We found no relations between ASD knowledge, stigmatizing attitudes and demographic variables. In conclusion, ASD knowledge and stigmatizing attitudes toward mental illness in Dutch YFC physicians require attention. Show less
Experiencing shame and guilt is painful but these emotions have an important social function. They prevent socially inappropriate behaviors as they make us aware of norms and values that are... Show moreExperiencing shame and guilt is painful but these emotions have an important social function. They prevent socially inappropriate behaviors as they make us aware of norms and values that are necessary for creating and maintaining social harmony. Participation in the social world is crucial for the development of shame and guilt, and less access to the social world could therefore be detrimental to this development. In this thesis, the influence of access to the social world on the development of self-conscious emotions is examined in two groups with less access to the social world: adolescents with an autism spectrum disorder (ASD) and adolescents with hearing loss. In addition, this thesis aimed to unravel the longitudinal contributions of shame and guilt on the development of adolescent aggression. Adolescents with diminished access to the social world reported lower levels of shame and guilt. The longitudinal relationships applied to both adolescent with diminished access and typically developing adolescents. It was demonstrated that shame is a risk factor for the development of reactive aggression, and that guilt is an inhibiting force on the development of bullying and proactive aggression Show less
Moffat, J.J.; Jung, E.M.; Ka, M.; Smith, A.L.; Jeon, B.T.; Santen, G.W.E.; Kim, W.Y. 2019
BACKGROUND: In genome-wide screening studies for de novo mutations underlying autism and intellectual disability, mutations in the ADNP gene are consistently reported among the most frequent. ADNP... Show moreBACKGROUND: In genome-wide screening studies for de novo mutations underlying autism and intellectual disability, mutations in the ADNP gene are consistently reported among the most frequent. ADNP mutations have been identified in children with autism spectrum disorder comorbid with intellectual disability, distinctive facial features, and deficits in multiple organ systems. However, a comprehensive clinical description of the Helsmoortel-Van der Aa syndrome is lacking.METHODS: We identified a worldwide cohort of 78 individuals with likely disruptive mutations in ADNP from January 2014 to October 2016 through systematic literature search, by contacting collaborators, and through direct interaction with parents. Clinicians filled in a structured questionnaire on genetic and clinical findings to enable correlations between genotype and phenotype. Clinical photographs and specialist reports were gathered. Parents were interviewed to complement the written questionnaires.RESULTS: We report on the detailed clinical characterization of a large cohort of individuals with an ADNP mutation and demonstrate a distinctive combination of clinical features, including mild to severe intellectual disability, autism, severe speech and motor delay, and common facial characteristics. Brain abnormalities, behavioral problems, sleep disturbance, epilepsy, hypotonia, visual problems, congenital heart defects, gastrointestinal problems, short stature, and hormonal deficiencies are common comorbidities. Strikingly, individuals with the recurrent p.Tyr719* mutation were more severely affected.CONCLUSIONS: This overview defines the full clinical spectrum of individuals with ADNP mutations, a specific autism subtype. We show that individuals with mutations in ADNP have many overlapping clinical features that are distinctive from those of other autism and/or intellectual disability syndromes. In addition, our data show preliminary evidence of a correlation between genotype and phenotype. Show less
This study considers the acquisition of epistemic modal auxiliaries (EMA) in typically developing (TD) and autistic children and the role that Theory of Mind (ToM) plays in this development.... Show moreThis study considers the acquisition of epistemic modal auxiliaries (EMA) in typically developing (TD) and autistic children and the role that Theory of Mind (ToM) plays in this development. Nineteen Dutch-speaking TD children and ten autistic children received tasks assessing ToM, general linguistic ability and EMA comprehension. Results suggest that both groups have some understanding of the Dutch EMA system, but no significant differences were found between groups. However, once participants were divided into ToM passers and ToM failers irrespective of clinical diagnosis, results showed that passers performed significantly better than failers on EMA understanding. Having a good understanding of others’ mental states, as evidenced by full marks on ToM tasks, thus seems important in the acquisition of EMA. Show less
Peer influence plays a crucial role in the rise of health-risk behaviors during adolescence. However, there is increasing evidence that peer influence can also lead to positive psychosocial... Show morePeer influence plays a crucial role in the rise of health-risk behaviors during adolescence. However, there is increasing evidence that peer influence can also lead to positive psychosocial outcomes, such as prosocial behavior. The main goal of this thesis was to investigate peer influence on risk-taking and prosocial behavior in adolescence and to unravel its underlying neural processes. Findings showed that effects of peers on risk-taking behavior are dependent on the context. Adolescents take into account both social norms from peer feedback and the uncertainty associated with outcomes in risky decisions. Moreover, peers can both increase and decrease prosocial behavior in typically developing (TD) adolescents and those with autism spectrum disorders (ASD), illustrating that peer influence can also lead to more adaptive outcomes. Finally, we studied the neural processes underlying prosocial peer feedback and results indicate that prosocial peer influence is underlined by the social brain network, regions involved in thinking about the self and others. Eventually, the results of this thesis can contribute to interventions aimed at decreasing risk-taking and promoting prosocial behavior in adolescence, with possibly long lasting effects into adulthood. Show less
Goddard, M.N.; Rijn, S. van; Rombouts, S.A.R.B.; Swaab, H. 2016
Growing evidence highlights the importance of visual-spatial processing skills (VSPS) but teaching and training of these skills at early age in schools remain understudied. To this end, we have... Show moreGrowing evidence highlights the importance of visual-spatial processing skills (VSPS) but teaching and training of these skills at early age in schools remain understudied. To this end, we have developed a computerized application called TangSolver that aim to move one step toward assessment and training of VSPS of school age children. First, we compared the effectiveness of an experimental computerized VSPS-enhancing approach, a conventional face-to-face training regime, and a non-training control group in improving performance in a tangram game among typical children. Second, we investigated how training-resistant possible visuospatial processing differences between children with and without ASD are. We studied the effect of computerized vs. face-to-face visuospatial training in a group of normally intelligent children with ASD and typically developing children as control. Findings show that (a) children with and without ASD do not differ much in visuospatial processing (as assessed by a tangram-like task) and the few differences we observed were all eliminated by training; (b) training can improve visuospatial processing (equally) in both children with ASD and normally developing children; and (c) computer-based and face-to-face training was equally effective. Show less
Rijn, S. van; Stockmann, L.; Borghgraef, M.; Bruining, H.; Ravenswaaij-Arts, C. van; Govaerts, L.; ... ; Swaab, H. 2014
In this thesis we examine how different aspects of emotion regulation are linked to social functioning and psychopathology in children and adolescents with Autism Spectrum Disorder (ASD) compared... Show moreIn this thesis we examine how different aspects of emotion regulation are linked to social functioning and psychopathology in children and adolescents with Autism Spectrum Disorder (ASD) compared to their typically developing (TD) peers. We take a broad perspective on emotion regulation by examining i) Emotion awareness, ii) Coping, and iii) Empathy. Main findings where that children with ASD scored lower on social functioning and higher on internalizing behavior, compared to their TD peers. Furthermore, all three aspects of emotion regulation were related with social functioning and psychopathology in both groups. Although children with ASD appeared to be motivated to engage in peer interactions, cognitive and affective impairments may prevent them from effectively deal with the own and other__s emotions. This thesis showed that internalizing and externalizing behavior in children with ASD mainly stems from impaired emotion regulation. Clinical implications and suggestions for further research are also given. Show less
Bildt, A. de; Oosterling, I.J.; Lang, N.D.J. van; Kuijper, S.; Dekker, V.; Sytema, S.; ... ; Jonge, M.V. de 2013
Children with autism and intellectual disability form a particularly vulnerable group, as both disorders have a significant impact on the way and level of information processing and communication.... Show moreChildren with autism and intellectual disability form a particularly vulnerable group, as both disorders have a significant impact on the way and level of information processing and communication. However, children with autism and co-occurring intellectual disability are often excluded from research. Therefore, this study focused on problems in functions, forms, and content of communication by comparing children with autism and intellectual disability with children with intellectual disability only and typically developing children. The results showed that low-functioning children with autism, especially nonverbal children, have severe problems in the use of communicative functions (Chapter 3). In children with autism and intellectual disability receptive language is generally more impaired than expressive language. Joint attention and symbolic skills are strongly related to concurrent language skills (Chapter 4). Because of the limited symbol understanding in low-functioning children with autism, level of sense-making has to be taken into account before starting interventions (Chapter 5). Relative strengths in visual perception can be used to offer the best suitable intervention (Chapter 6). The results of our study emphasize that communicative interventions should have improvement and support of language comprehension as a key target, but also should target the motivation to communicate. Show less
Bildt, A. de; Oosterling, I.J.; Lang, N.D.J. van; Sytema, S.; Minderaa, R.B.; Engeland, H. van; ... ; Jonge, M.V. de 2011
Aim of the dissertation: To expand the knowledge on the behavioural phenotypes, level of parenting stress and the relationship between child characteristics and parenting stress in five genetic... Show moreAim of the dissertation: To expand the knowledge on the behavioural phenotypes, level of parenting stress and the relationship between child characteristics and parenting stress in five genetic syndromes. The included syndromes are Angelman, CHARGE, Cornelia de Lange, Prader-Willi, and Rett syndrome. All syndromes are associated with intellectual disabilities. Method: Participants were children and adults with one of the syndromes and their parents, recruited through the Dutch Parent Support Groups. Parents filled out questionnaires concerning parenting stress and behavioural characteristics of their child. Additionally an interview regarding autistic traits of the child was administrated with parents. Main results: The behavioural phenotypes of the syndromes are described in detail. In all syndromes there is a high risk to display autistic traits. The syndromes can been seen as a risk factor for high levels of parenting stress. Specialized psycho-education on the behavioural strengths and weaknesses of a specific syndrome should be given to parents. Awareness on the high prevalence of autistic traits is important to be able to shape an optimum adaptive environment. Professionals should not only focus on the child with the syndrome, but also on the family system given the high stress levels for parents. Show less
