Sunday, October 26, 2014

Emotional Intelligence (EI) and Asperger Syndrome



Emotional intelligence (EI) is broadly defined as the ability to identify, assess, and control the emotions of oneself, of others, and of groups. The interest and research relating to EI has grown dramatically over the past decade. Currently, there are two emotional intelligence constructs: ability EI (or cognitive-emotional ability) and trait EI (or trait emotional self-efficacy). They are differentiated by the type of measurement used in the operationalization process. For example, the ability perspective conceives EI as a form of intelligence best assessed via performance tests and has stronger relationships with cognitive ability hierarchies. Thus, ability EI refers to individual differences in the ability to process and use emotional information to promote effective functioning in everyday life. Trait EI concerns behavioral dispositions and self-perceived abilities and is measured through self-report. Trait EI has stronger relationships with personality and concerns people’s perceptions of their emotional abilities (how good we believe we are in understanding and managing our own and other people’s emotions, rather than how good we actually are). These perceptions are generally stable over time and have a direct influence on mood, behavior, achievement, and action. In other words, trait EI is defined, not as a cognitive ability, but as a collection of personality traits concerning people's perceptions of their emotional abilities. 
Trait EI and ASD  
The defining feature of autism spectrum disorders (ASD) is impairment in interpersonal relating and communication. This includes difficulty communicating with others, processing and integrating information from the environment, establishing and maintaining reciprocal social relationships, taking another person’s perspective, inferring the interests of others, and transitioning to new learning environments. While all individuals with ASD experience core social-communication deficits, we now recognize that autism-related traits are quantitatively distributed in the general population and that autism is best conceptualized as a spectrum disorder, rather than a categorical diagnosis. Even mild degrees of what might be called autistic social impairment can significantly interfere with adaptive behavior. Likewise, a combination of mild autistic symptomatology and other psychological liabilities (e.g., attention problems, mood problems, aggression) can have an adverse effect on social and emotional adjustment. Unfortunately, the core features of ASD may not diminish with development. Typically, individuals do not ‘‘outgrow’’ their deficits. Distress may actually increase as the social milieu becomes more complex and challenging. These difficulties may then persist well into adulthood and lead to comorbid emotional symptoms. Indeed, high stress, anxiety and depression are regularly present in persons with ASD.
ASD involves deficits that are directly relevant to the constellation of emotional self-perceptions encompassed by trait EI. Trait emotional intelligence (trait EI) encompasses many of the aspects of social-emotional functioning that have been shown to be impaired in ASD in the form of self-perceptions. Research has begun to examine the link between higher functioning ASD (e.g., Asperger syndrome) and trait EI. A recent study compared the trait EI profiles of men and women diagnosed with Asperger syndrome (AS) with those of a normative sample, group-matched on age and gender. Participants were thirty adults diagnosed with AS (16 women and 14 men) who volunteered for the study and were subsequently group-matched with 43 typically developing adults (22 women and 21 men). There were no significant differences in the mean age of the participants with and without AS and no significant between-group differences in the distribution of gender. All participants completed the Trait Emotional Intelligence Questionnaire (TEIQue), a self-report inventory specifically designed to comprehensively measure the trait EI construct. The TEIQue consists of 153 items rated on a 7-point scale ranging from 1 (strongly disagree) to 7 (strongly agree) and includes 15 subscales (facets) organized under four factors (Well-Being, Self-Control, Emotionality, and Sociability) and global trait EI. It has been shown to have satisfactory psychometric properties in various studies. Below is a list of the 15 trait EI facets, along with a brief description of each.  These facets comprise the current sampling domain of trait emotional intelligence in adults and adolescents.   
Facets                                                    High scorers perceive themselves as…
Adaptability                                           flexible and willing to adapt to new conditions.
Assertiveness                                         forthright, frank, & willing to stand up for rights.
Emotion perception (self; others)     clear about their own & other people’s feelings.
Emotion expression                             capable of communicating their feelings to others.
Emotion management (others)         capable of influencing other people’s feelings.
Emotion regulation                              capable of controlling their emotions.
Impulsiveness (low)                             reflective & less likely to give in to their urges.
Relationships                                         capable of having fulfilling personal relationships.
Self-esteem                                             successful & self-confident.
Self-motivation                                      driven & unlikely to give up in the face of adversity.
Social awareness                                   accomplished networkers with excellent social skills.
Stress management                              capable of withstanding pressure & regulating stress.
Trait empathy                                        capable of taking someone else’s perspective.
Trait happiness                                      cheerful & satisfied with their lives.
Trait optimism                                       confident & likely to “look on the bright side” of life.
Findings and Implications  
The researchers hypothesized if individuals with Asperger syndrome have limited understanding their social-communication deficits, then they would score similarly to typical adults on the TEIQue. However, if they have an accurate understanding of these deficits, then they would score significantly lower. The researchers also sought to shed light on the gender discrepancy routinely observed in ASD, particularly in those more able individuals diagnosed with ASD.
The results showed that individuals with AS had significantly lower scores on most TEIQue variables, including the global trait EI score. The Asperger group scored significantly lower on 12 out of the 15 facets of the Trait Emotional Intelligence Questionnaire (TEIQue). They rated themselves particularly low on questions relating to social awareness, emotion management, adaptability, empathy, and emotion perception. The finding appears to be consistent with the clinical presentation of ASD. Differences were much smaller, or non-existent, on questions relating to self-control (especially, impulse control and emotion control). With respect to gender, males scored higher than females, albeit with small effect sizes. Overall, the findings suggest that individuals with Asperger syndrome have insight into the nature of their condition and are aware of the strengths and weaknesses of their personality. These data also suggest that the female phenotype of AS may be associated with greater impairment than the male phenotype.
This research contributes to the evidence documenting the effect of trait EI self-perceptions and dispositions on socio-emotional development and overall psychological well-being. The well-being component of trait EI may be especially relevant in the adjustment process, since positive emotions contribute to the development of those physical, intellectual and social resources necessary to cope successfully with the demands of the social world. There are extensive individual differences in people's perceptions of their emotional abilities. Because trait EI affects behavior, self-referent cognitions and mental health, it is an important variable to consider in the evaluation and treatment of higher functioning individuals with ASD. Although individuals with ASD appear to be aware of their social-communication deficits, further study is needed into the capacity for insight and how it may be utilized in treatment/intervention. Likewise, further study is also needed to examine the relationship of trait EI variables to symptom severity and determine to what extent individual self-perceptions predict outcomes (e.g., life satisfaction, coping strategies, and job performance).  Perceived emotional self-efficacy also plays an important role in emotion management and regulation in education. Consequently, further research on trait EI should include children with ASD. A child version of the TEIQue (TEIQue-Child Form) is available for children aged between 8 and 12 years of age and measures nine distinct facets. An examination of trait EI profiles of children with ASD may assist with identification, intervention, and progress monitoring.
Petrides, K. V., Hudry, C., Michalaria, G., Swami, V., & Sevdalis, N. (2011). Comparison of the trait emotional intelligence profiles of individuals with and without Asperger syndrome. Autism, 15, 671–682. doi 10.1177/1362361310397217
Detailed information about trait EI and the various facets of the TEIQue can be found at http://www.psychometriclab.com 
The online version of this article can be found at http://aut.sagepub.com/content/15/6.toc

Lee A. Wilkinson, PhD is the author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers. He is also the editor of a best-selling text in the APA School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools, and author of the book, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT. Dr. Wilkinson's latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools, (2nd Edition).

Thursday, October 9, 2014

Role of Parental Occupation in Autism Diagnosis and Severity

Children of fathers in healthcare and finance have greater risk of having offspring with ASD while children of parents with technical occupations exhibit greater ASD severity, according to researchers at The University of Texas Health Science Center at Houston (UTHealth). The findings were presented at the International Meeting for Autism Research (IMFAR) in Atlanta and appear in the peer reviewed journal, Research in Autism Spectrum Disorders.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments in (a) social communication and (b) restricted and/or repetitive behaviors or interests that varies in severity of symptoms, age of onset, and association with other disorders. According to recent estimates, approximately 1 in 68 children in the United States has an ASD diagnosis. In addition, a recent study of parent reports suggests that prevalence of ASD in the US could be as high as 1 in 50.  Despite this growing literature on prevalence and incidence of ASD, less is known about the etiology of this complex neurodevelopmental disorder.
It has been suggested that parents of children with autism spectrum disorder (ASD) may present with less recognizable autistic-like phenotypic characteristics or traits (broader ASD phenotype), leading them to highly systemizing occupations such as science, engineering, mathematics, computer science, accounting, and medicine. Others have suggested that many professionals with highly systemizing occupations are functioning with undiagnosed ASD. Using secondary analysis of data from two previous studies of children with ASD, the researchers tested associations between parental occupations and ASD diagnosis and the association of parental occupational characteristics on ASD severity. Children for both studies were recruited from the same educational, clinical, and community sources. Suspected ASD cases were determined by clinical interview and observation.  Those meeting DSM-IV-TR criteria were administered both the Autism Diagnostic Interview, Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) to confirm diagnosis. Parental occupations were established through demographic questionnaires during assessment. The researchers used the Standard Occupational Classification (SOC) system to classify occupational characteristics of interest. Parents were divided into those who had more non-people-oriented jobs (technical) or more people-oriented jobs (non-technical).  For example, those working in engineering, scientific research, and accounting were considered having technical, white-collar occupations while those in healthcare professions were consider having non-technical, white-collar positions. Statistical analyses were used to explore associations of ASD status with certain white-collar occupations and occupational characteristics and to investigate differences in mean ADOS and ADI-R domain and total scores for parental occupation characteristics.
The results indicated that for paternal occupations, fathers who worked in engineering were two times as likely to have a child with an autism spectrum disorder (ASD) as compared to all other white-collar occupations. Additionally, fathers of ASD cases were seven times more likely to work in healthcare occupations and five times more likely to work in accounting/financial analysis. There was no association with a mother's occupation. However, children who had both parents in technical fields were associated with significant social impairment and a higher risk of having more severe overall autistic symptomatology.
The findings suggest that there is a joint association between parental occupation and ASD severity, as well as a relationship between paternal occupation and ASD diagnosis. These results are also supportive of a “broader ASD phenotype” in parents of children with ASD which includes individuals with mild impairments in social and communication skills that are similar to those shown by individuals with ASD, but exhibited to a lesser degree. The tendency of people with autistic-like characteristics to marry (assortative mating) might contribute to intergenerational transmission and having offspring with greater ASD severity. "Parental occupation could be indicative of autistic-like behaviors and preferences and serve as another factor in a clinician's diagnosis of a child with suspected autism. Medical students can be taught that this is one of the things to consider," said. Aisha S. Dickerson, first author of the study. More analysis should be done to determine what factors contribute to occupation choices, and how these factors, if identifiable, can add to the risk of communication or social impairment in the offspring of these individuals.
Dickerson, A. S., Pearson, D. A., Loveland, K. A., Rahbar, M. H.,  & Filipek, P. A. (2014).
Role of Parental Occupation in Autism Spectrum Disorder Diagnosis and Severity. Research in Autism Spectrum Disorders, 8, 997–1007

Monday, October 6, 2014

Independent Living and Young Adults with ASD

There has been a dramatic worldwide increase in reported cases of autism over the past decade. The prevalence rates in the US have risen steadily, from one in 150, to one in 110, and now to one in every 68 American children. This represents a 78 percent increase in the number of children identified with an autism spectrum disorder (ASD) over the past decade. The increase in the prevalence of ASD among children indicates that a correspondingly large number of youth will be transitioning into adulthood in the coming years. It is estimated that approximately 50,000 adolescents with autism will turn 18 years old this year in the U.S. As these numbers continue to rise, there is a pressing need to understand the transition experience of young adults with ASD in today’s world.
According to a study published in the journal Autism, young adults with ASD are more likely to live with their parents and least likely to live independently after leaving high school as compared to those with other types of disabilities. For the study, researchers examined the prevalence and correlates of three living arrangements (with a parent or guardian, independently or with a roommate, or in a supervised setting) among a nationally representative sample of 620 postsecondary young adults with ASD since leaving high school. They were compared with 450 individuals with intellectual disability (InD), 410 with learning disabilities (LD) and 380 with emotional disturbance (ED) who were all part of the National Longitudinal Transition Study-2, a long-term federally-funded survey of students in special education and their parents.
Compared with young adults with other disability types, young adults with an ASD were significantly more likely to have ever lived with a parent or guardian (87.1%) and less likely to have ever lived independently (16.6%) since leaving high school. In follow-up analyses, the researchers found no independent living among young adults with ASD who had been out of high school for 2 years or less at the time of the survey. In contrast, the comparable rate was 22.2% for youth in InD group.
Overall, the study’s findings show that young adults with an ASD have a different residential transition experience than their peers with LD, ED, or InD. Young adults with an ASD resided with a parent or guardian at higher rates and for longer periods of time after leaving high school than young adults with other disabilities. Moreover, young adults with an ASD had the highest rate of supervised living arrangements and the lowest rate of independent living since leaving high school. These results suggest that young adults with an ASD are particularly vulnerable during the initial years in the transition to adulthood where they experience a shift in service provision after leaving high school. Consequently, many young adults with an ASD are not experiencing opportunities to explore various residential options as young adults.
The evidence presented in this study suggests that the vast majority of young adults with ASD will be residing in the parental or guardian home during the period of emerging adulthood. The lack of services available to help young adults with ASD transition to greater independence has been noted by researchers for a number of years and has become an increasingly important issue as children identified with ASD reach adolescence and adulthood. More research is needed to identify ways to effectively implement residential transition plans that best meet the needs and pref­erences of young adults with ASD and their families. Research suggests that prolonged caregiving of an adult child with autism can adverse effects on maternal well-being. Thus, investigating a variety of in-home interventions that might improve the qual­ity of life for families and adults with ASD may be helpful in that the vast majority of young adults are residing in the parental home. Lastly, the focus of intervention/treatment must shift from remediating the core deficits in childhood to promoting adaptive behaviors in secondary education that can facilitate and enhance ultimate functional independence and quality of life in adulthood. This includes addressing new developmental challenges such as independent living, vocational engagement, postsecondary education, and family support.
Prevalence and correlates of postsecondary residential status among young adults with an autism spectrum disorder. Kristy A Anderson, Paul T Shattuck, Benjamin P Cooper, Anne M Roux and Mary Wagner. Autism published online 30 August 2013. DOI: 10.1177/1362361313481860
The online version of this article can be found at: http://aut.sagepub.com/content/early/2013/08/27/1362361313481860

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