Predicting peer acceptance and peer rejection for autistic children

Journal of Autism and Developmental Disorders, 30(3), 205-223

Autism spectrum disorders are now recognized to occur in up to 1% of the population and to be a major public health concern because of their early onset, lifelong persistence, and high levels of associated impairment. Little is known about the associated psychiatric disorders that may contribute to impairment. We identify the rates and type of psychiatric comorbidity associated with ASDs and explore the associations with variables identified as risk factors for child psychiatric disorders. A subgroup of 112 ten- to 14-year old children from a population-derived cohort was assessed for other child psychiatric disorders (3 months' prevalence) through parent interview using the Child and Adolescent Psychiatric Assessment. DSM-IV diagnoses for childhood anxiety disorders, depressive disorders, oppositional defiant and conduct disorders, attention-deficit/hyperactivity disorder, tic disorders, trichotillomania, enuresis, and encopresis were identified. Seventy percent of participants had at least one comorbid disorder and 41% had two or more. The most common diagnoses were social anxiety disorder (29.2%, 95% confidence interval [CI)] 13.2-45.1), attention-deficit/hyperactivity disorder (28.2%, 95% CI 13.3-43.0), and oppositional defiant disorder (28.1%, 95% CI 13.9-42.2). Of those with attention-deficit/hyperactivity disorder, 84% received a second comorbid diagnosis. There were few associations between putative risk factors and psychiatric disorder. Psychiatric disorders are common and frequently multiple in children with autism spectrum disorders. They may provide targets for intervention and should be routinely evaluated in the clinical assessment of this group.

This meta-analytic review of 148 studies on child and adolescent direct and indirect aggression examined the magnitude of gender differences, intercorrelations between forms, and associations with maladjustment. Results confirmed prior findings of gender differences (favoring boys) in direct aggression and trivial gender differences in indirect aggression. Results also indicated a substantial intercorrelation (r = .76) between these forms. Despite this high intercorrelation, the 2 forms showed unique associations with maladjustment: Direct aggression is more strongly related to externalizing problems, poor peer relations, and low prosocial behavior, and indirect aggression is related to internalizing problems and higher prosocial behavior. Moderation of these effect sizes by method of assessment, age, gender, and several additional variables were systematically investigated.