OBJECTIVE: Autism spectrum disorder (ASD) is associated with abnormal lipid metabolism, such as a high total ratio of omega-6 to omega-3 in polyunsaturated fatty acids (PUFAs). PUFAs are metabolized to epoxy fatty acids by cytochrome P450 (CYP); then, dihydroxy fatty acid is produced by soluble epoxide hydrolase. This study examined the association between PUFA metabolites in the cord blood and ASD symptoms and adaptive functioning in children.
METHODS: This prospective cohort study utilized cord blood to quantify PUFA metabolites of the CYP pathway. The Autism Diagnostic Observation Schedule (ADOS-2) and Vineland Adaptive Behaviors Scales, Second Edition (VABS-II) were used to assess subsequent ASD symptoms and adaptive functioning in children at 6 years. The analysis included 200 children and their mothers.
RESULTS: Arachidonic acid-derived diols, 11,12-diHETrE was found to impact ASD symptom severity on the ADOS-2-calibrated severity scores and impairment in the socialization domain as assessed by the VABS-II (P = 0.0003; P = 0.004, respectively). High levels of 11,12-diHETrE impact social affect in ASD symptoms (P = 0.002), while low levels of 8,9-diHETrE impact repetitive/restrictive behavior (P = 0.003). Notably, there was specificity in the association between diHETrE and ASD symptoms, especially in girls.
CONCLUSIONS: These findings suggest that the dynamics of diHETrE during the fetal period is important in the developmental trajectory of children after birth. Given that the role of diol metabolites in neurodevelopment in vivo is completely uncharacterized, the results of this study provide important insight into the role of diHETrE and ASD pathophysiology.

Autism spectrum disorder (ASD) is a heterogeneous condition that affects development and functioning from infancy through adulthood. Efforts to parse the heterogeneity of the autism spectrum through subgroups such as Asperger\'s and Profound Autism have been controversial, and have consistently struggled with issues of reliability, validity, and interpretability. Nonetheless, methods for successfully identifying clinically meaningful subgroups within autism are needed to ensure that research, interventions, and services address the range of needs experienced by autistic individuals. The purpose of this study was to generate and test whether a simple set of questions, organized in a flowchart, could be used in clinical practice and research to differentiate meaningful subgroups based on individuals\' level of functioning. Once generated, subgroups could also be compared to the recently proposed administrative category of Profound Autism and to groupings based on standardized adaptive measures. Ninety-seven adults with autism or related neurodevelopmental disorders participating in a longstanding longitudinal study, or their caregivers if they could not answer for themselves, completed phone interviews when the participants were ~30 years old. Information from these phone interviews was used to generate vignettes summarizing characteristics and aspects of the daily lives of each participant (e.g., language level, vocational activities, and social relationships). Three expert clinicians then used these vignettes to classify each participant based on their level of support needs. Meaningfully distinct subgroups within the sample were identified which could be reliably distinguished from one another. Implications of such categorizations and future directions are discussed.

OBJECTIVE: In the context of developmental trajectories, the association between adaptive functioning and core autism symptomatology remains unclear. The current study examines the associations of adaptive behavior with autism symptom sub-domains and with different facets of symptom expression.
METHODS: Participants include 36 children with a recent diagnosis of autism (33 males; mean age = 56.4 months; SD = 9 months). Families were recruited in the context of the Pediatric Autism Research Cohort (PARC) project. Parents filled out questionnaires at two time points, six months apart, regarding their child\'s autism symptoms and adaptive functioning. The longitudinal relationship between adaptive functioning and autism symptoms was investigated using Mixed Linear Model analyses: one assessing the relationship between general symptom levels and adaptive functioning, and another examining the associations between symptom frequency and impact with adaptive functioning. We conducted Pearson correlation tests at both time points to assess the associations between symptom sub-domains and adaptive functioning.
RESULTS: Findings showed that higher autism symptoms associated with lower adaptive behavior skills, and that this association remained stable over time. Autism impact scores did not significantly relate to adaptive skills, as opposed to frequency scores. Associations between adaptive functioning and autism symptom sub-domains strengthened over time.
CONCLUSIONS: These findings suggest that adaptive functioning is associated with parent-report autism symptomatology, and that this association changes and, on average, becomes stronger over time. Findings may indicate that frequency and impact of symptoms have differential roles in the development of adaptive skills and are worthy of further exploration.

The definitions of \"slow learners\" and \"borderline intellectual functioning (BIF)\" have not reached a consensus and have continually evolved in terminology. The criteria for diagnosing BIF include the Full-Scale Intelligence Quotient, adaptive functioning, and onset of symptoms from the developmental period; however, specific standards have not been provided. Until the Diagnostic and Statistical Manual of Mental Disorders-IV, a range for the Full-Scale Intelligence Quotient was provided, but due to its limitations in reflecting the actual functioning of individuals with BIF, this criterion was removed from the Diagnostic and Statistical Manual of Mental Disorders-5. The absence of specific diagnostic criteria complicates the identification of individuals with BIF, highlighting the need for a more precise classification and definition.

Objective: Survivors of pediatric brain tumors are at increased risk of executive function (EF) and adaptive behavior difficulties. While previous research suggests that executive dysfunction impacts suboptimal adaptive outcomes, the specific elements of EF influencing this relationship remain unexplored. This study examines the relationship between cognitive flexibility and adaptive behavior in survivors compared to healthy controls. Methods: 86 survivors (Mage(SD)=23.41(4.24), 44 females) and 86 controls (Mage(SD)=23.09(4.50), 44 females) completed the Delis-Kaplan Executive Function System Trail Making Test (TMT) and Verbal Fluency Test (VFT). The Letter-Number Sequencing (LNS) and Category Switching (CS) conditions were isolated as measures of cognitive flexibility. Informants provided responses to obtain adaptive behavior ratings using the Scales of Independent Behavior-Revised (SIB-R). Linear regressions explored relationships between cognitive flexibility and SIB-R scores in survivors compared to controls. Results: For both TMT and VFT, the relationship between cognitive flexibility and adaptive behavior was significantly different between survivors and controls for SIB-R scores in Social Communication, Community Living, and Personal Living Skills (p<.0125). Survivors\' better LNS performance predicted greater SIB-R scores across the same 3 domains (all p= <.001, r2semipartial=.08). Similarly, survivors\' better CS performance predicted greater SIB-R scores across the same 3 domains (p = 0.002 to .02, r2semipartial =.03 to .04). No significant relationships were found in controls (all p >.05). After adjusting for working memory and inhibitory control, most relationships remained significant in survivors (p= <.001 to .046, r2semipartial=.02 to .08). Conclusion: These findings reveal a robust, positive relationship between cognitive flexibility performance and adaptive behaviors specific to survivors.

Congenital heart disease (CHD) is one of today\'s leading birth anomalies. Children with CHD are at risk for adaptive functioning challenges. Sleep difficulties are also common in children with CHD. Indeed, sleep-disordered breathing, a common type of sleep dysfunction, is associated with increased mortality for infants with CHD. The present study examined the associations between adaptive functioning and sleep quality (i.e., duration and disruptions) in children with CHD (n = 23) compared to healthy children (n = 38). Results demonstrated associations between mean hours slept and overall adaptive functioning in the CHD group r(21) = .57, p = .005 but not in the healthy group. The CHD group demonstrated lower levels of adaptive functioning in the Conceptual, t(59) = 2.12, p = .039, Cohen\'s d = 0.53 and Practical, t(59) = 2.22, p = .030, Cohen\'s d = 0.55 domains, and overall adaptive functioning (i.e., General Adaptive Composite) nearing statistical significance in comparison to the healthy group, t(59) = 2.00, p = .051, Cohen\'s d = 0.51. The CHD group also demonstrated greater time awake at night, t(56) = 2.19, p = .033, Cohen\'s d = 0.58 and a greater instance of parent-caregiver reported snoring, χ2 (1, N = 60) = 5.25, p = .022, V = .296 than the healthy group. Further exploration of the association between adaptive functioning and sleep quality in those with CHD is required to inform clinical practice guidelines.

BACKGROUND: This study aims to describe maternal depressive symptoms (MDS) trajectories in a longitudinal study extending from pregnancy to 27 years after the birth of the firstborn child. We also explored the associations of both MDS trajectories and child internalizing and externalizing problem trajectories with maternal adjustment (adaptive functioning, emotional and behavioral problems).
METHODS: The population-based study was conducted in Tampere, Finland, and the sample comprised 356 first-time mothers. MDS were screened with the Edinburgh Postnatal Depression Scale during pregnancy, first week after delivery, 2 and 6 months postnatally, and when the child was 4-5, 8-9, 16-17, and 26-27 years of age. The internalizing and externalizing problems of the children were assessed with the Child Behavior Checklist when the child was 4-5, 8-9, and 16-17 years of age. Maternal adaptive functioning and internalizing and externalizing problems were assessed with the Adult Self Report at 26-27 years after the birth of the first child. Complete follow-up data were available for 168 mothers.
RESULTS: We describe a three-group trajectory model of MDS (High Stable, Low Stable, Very Low). Elevated depressive symptom patterns were associated with less optimal maternal outcomes regarding both adaptive and problem dimensions. The child\'s internalizing and externalizing problem trajectories were associated with maternal internalizing and externalizing problems but not with maternal adaptive functioning.
CONCLUSIONS: Maternal and child measures were based on maternal reports only.
CONCLUSIONS: The interconnectedness of the well-being of the mother and child should be noted in health and mental health services for adults and children.

UNASSIGNED: Previous research has demonstrated heterogeneous adaptive outcomes across the autism spectrum; however, the current literature remains limited in elucidating turning points and associated factors for longitudinal variability (chronogeneity). To address these empirical gaps, we aimed to provide a finer-grained characterization of trajectories of adaptive functioning from early childhood to adolescence in autism.
UNASSIGNED: Our sample (N = 406) was drawn from an inception cohort of children diagnosed Autistic at ages 2-5. Adaptive functioning was assessed with Vineland Adaptive Behavior Scales (VABS, 2nd Edition) across 6 visits from the time of diagnosis by age 18. Parallel-process latent growth curve modeling were used to estimate domain-level VABS trajectories, followed by latent class growth analysis to identify trajectory subgroups. Child characteristics at diagnosis, family demographics, and participation outcomes at adolescence were compared across subgroups.
UNASSIGNED: Piecewise latent growth models best described VABS trajectories with two turning points identified at around ages 5-6 and 9-10, respectively reflecting transitions into school age and early adolescence. We parsed four VABS trajectory subgroups that vary by level of functioning and change rate for certain domains and periods. Around 16% of the sample exhibited overall adequate functioning (standard score >85) with notable early growth and social adaptation during adolescence. About 21% showed low adaptive functioning (standard score ≤70), with decreasing slopes by age 6 followed by improvements in communication and daily-living skills by age 10. The other two subgroups (63% in total) were characterized by adaptive functioning between low and adequate levels, with relatively stable trajectories entering school age. These subgroups differed most in their cognitive ability at diagnosis, household income, and social participation in adolescence.
UNASSIGNED: We identified key individual and family characteristics and time windows associated with distinct adaptive functioning trajectories, which have important implications for providing timely and tailored supports to Autistic people across developmental stages.

Adaptive functioning is central to autistic individuals\' independence and well-being. However, autism spectrum disorder (ASD) is associated with poor adaptive functioning, even in the absence of cognitive delays or deficits. This study examined how age and executive function associate with adaptive functioning-particularly the gap between cognitive and adaptive functioning. We addressed our research questions separately for a school-age (N = 101 ages 7-12) cohort and a preschool (N = 48 ages 2 and 4) cohort of autistic children without cognitive delays. Both cohorts of parents reported on their children\'s adaptive and executive functioning skills. The difference between adaptive and cognitive skills was computed for each participant. For each cohort, we evaluated whether adaptive skills decline with age. Next, we measured, in each cohort, whether children\'s executive function corresponded with this gap between their adaptive and cognitive skills. Adaptive functioning did not decline relative to cognitive ability in the younger cohort, but the gap was present in the school-age cohort. Yet, reduced executive function consistently corresponded with a greater cognitive-adaptive gap in socialization domains for both preschool and school-age children. Targeting EF, specifically emotional control, during preschool years may support both adaptive functioning and social connectedness for autistic children without cognitive delays.

Whether and how remitted clinical depression in postpartum motherhood contributes to poor infant adaptive functioning is inconclusive. The present longitudinal study examines adaptive functioning in infants of mothers diagnosed as clinically depressed at 5 months but remitted at 15 and 24 months. Fifty-five U. S. mothers with early, remitted clinical depression and 132 mothers without postpartum depression completed the Vineland Adaptive Behavior Scales about their infants at 15 and 24 months. Between groups, mothers were equivalent in age, ethnicity, marital status, and receptive vocabulary (a proxy for verbal intelligence), and infants were equivalent in age and distribution of gender. Controlling for maternal education and parity, mothers with early, remitted clinical depression and mothers with no postpartum depression rated their infants similarly on communication, daily living skills, and socialization. Mothers with early, remitted clinical depression rated their infants poorer in motor skills. Girls were rated more advanced than boys in communication at 24 months and daily living skills at 15 and 24 months. Rated infant adaptive behavior skills increased from 15 to 24 months. With exceptions, adaptive functioning in infants may be robust to early, remitted maternal depression, and adaptive functioning presents a domain to promote positive development in this otherwise vulnerable population.
Si la depresión clínica remitida en la maternidad del período de postparto contribuye y cómo contribuye al débil funcionamiento de adaptación del infante es algo inconcluso. El presente estudio longitudinal examina el funcionamiento de adaptación en infantes de madres clínicamente deprimidas a los 5 meses, pero remitidas a los 15 y 24 meses. Cincuenta y cinco madres con una temprana depresión clínica remitida y 132 madres sin depresión en el período de postparto en los Estados Unidos completaron las Escalas Vineland del Comportamiento de Adaptación acerca de sus infantes de 15 y 24 meses de edad. Entre los grupos, las madres presentaban equivalencia en cuanto a la edad, la etnicidad, el estado marital, así como el vocabulario receptivo (un reemplazo para la inteligencia verbal), y los infantes presentaban equivalencia en edad y género. Con los factores de educación y paridad controlados, las madres con temprana depresión clínica remitida y las madres sin depresión en el período de postparto evaluaron a sus infantes similarmente en cuanto a la comunicación, las habilidades del diario vivir y la socialización. Las madres con temprana depresión clínica remitida evaluaron a sus infantes más pobremente en cuanto a habilidades motoras. A las niñas se les evaluó como más avanzadas que los varones en la comunicación a los 24 meses y en las habilidades del diario vivir a los 15 y 24 meses. Las evaluadas habilidades del comportamiento de adaptación de los infantes aumentaron de los 15 a los 24 meses. Con excepciones, el funcionamiento de adaptación en los infantes pudiera ser robusto en relación con la temprana depresión materna remitida, y el funcionamiento de adaptación presenta un dominio para promover el positivo desarrollo en este grupo de población que, de lo contrario, es vulnerable.
Ob und wie remittierte klinische Depressionen in der postpartalen Phase der Mutterschaft zu einer schlechten Anpassungsfähigkeit des Kindes beitragen, ist nicht eindeutig geklärt. Die vorliegende Längsschnittstudie untersucht die Anpassungsfähigkeit von Säuglingen, deren Müttern 5 Monate nach der Geburt klinisch depressiv waren, aber nach 15 und 24 Monaten remittierten. Fünfundfünfzig Mütter mit frühen, remittierten klinischen Depressionen und 132 Mütter ohne postpartale Depression aus den Vereinigten Staaten füllten 15 und 24 Monate nach der Geburt die „Vineland Adaptive Behavior Scales“ über ihre Säuglinge aus. Die Mütter beider Gruppen waren hinsichtlich Alter, ethnischer Zugehörigkeit, Familienstand und rezeptivem Wortschatz (stellvertretend für verbale Intelligenz) äquivalent. Die Säuglinge waren hinsichtlich Alter und Geschlecht äquivalent. Wenn für Ausbildung der Mutter und Parität kontrolliert wurde, beurteilten Mütter mit frühen, remittierten klinischen Depressionen und Mütter ohne postpartale Depressionen ihre Säuglinge in den Bereichen Kommunikation, Alltagskompetenz und Sozialisierung ähnlich. Mütter mit frühen, remittierten klinischen Depressionen beurteilten ihre Säuglinge in Bezug auf motorische Fähigkeiten schlechter. Mädchen wurden mit 24 Monaten in der Kommunikation und mit 15 und 24 Monaten in den Fertigkeiten des täglichen Lebens besser beurteilt als Jungen. Die Beurteilung der adaptiven Verhaltensfähigkeiten der Säuglinge nahm von 15 bis 24 Monaten zu. Von Ausnahmen abgesehen sind die Anpassungsfähigkeiten von Säuglingen möglicherweise robust gegenüber frühen, remittierten mütterlichen Depressionen und Anpassungsfähigkeit stellt ein Förderungsbereich für eine positive Entwicklung in dieser ansonsten gefährdeten Bevölkerungsgruppe dar.
産後に母親の臨床的うつ病が緩解した場合、乳児の適応機能の低下に寄与するかどうか、またどのように寄与するかについては結論が出ていない。本研究では、5ヵ月時に臨床的うつ病であったが15ヵ月時と24ヵ月時に寛解した母親の乳児における適応機能を縦断的に検討した。米国において、早期に臨床的うつ病が寛解した母親55名と産後うつ病でない母親132名が、15ヵ月と24ヵ月の乳児についてVineland Adaptive Behavior Scalesを記入した。群間で、母親の年齢、民族、配偶者の有無、受容語彙 (言語性知能の代理) は同等であり、乳児の年齢と性別も同等であった。母親の学歴と分娩数をコントロールし、早期に臨床的うつ病が寛解した母親と産後うつ病でない母親について、コミュニケーション、日常生活技能、社会性に関して乳児を比較検討した。早期に臨床的うつ病が寛解した母親は、乳児の運動技能が劣っていると評価した。女児は男児よりも、24ヵ月時のコミュニケーション、15ヵ月時と24ヵ月時の日常生活技能においてより高いと評価された。乳児の適応行動技能の評価は15ヵ月から24ヵ月にかけて上昇した。例外を除けば、乳児の適応機能は、早期に寛解した母親のうつ病に対して頑健である可能性があり、適応機能は、このような脆弱な集団の積極的な発達を促進する領域を提示している。.
关于产后临床抑郁症康复对婴儿适应功能不良的影响, 目前尚无定论。本研究采用纵向设计, 考察了在婴儿5个月时患有临床抑郁症但在15个月和24个月时已康复的母亲, 其婴儿的适应功能。美国55名患有早期临床抑郁症但已康复的母亲和132名无产后抑郁症的母亲完成了关于其婴儿“文兰适应行为量表”的评估, 评估时间点分别为婴儿15个月和24个月时。两组母亲的年龄、种族、婚姻状况和接受词汇量 (作为语言智力的替代指标) 相当, 婴儿的年龄和性别也相当。在控制母亲教育水平和生育次数均等因素的情况下, 患有早期临床抑郁症但已康复的母亲和没有产后抑郁症的母亲在沟通、日常生活技能和社交方面对其婴儿的评分相似。患有早期临床抑郁症但已康复的母亲评价其婴儿在运动技能方面较差。女婴在24个月大时的沟通能力以及在15个月和24个月大时的日常生活技能评分均高于男婴。婴儿的适应行为技能评分在15到24个月间有所增加。除了例外情况, 患有早期临床抑郁症但已康复的母亲其婴儿的适应功能可能相对健康, 并且适应功能提供了一个促进这一弱势群体积极发展的机会。.
إن مسألة مساهمة الاكتئاب السريري في الأمومة بعد الولادة في ضعف الأداء التكيفي للرضيع غير حاسمة. تبحث الدراسة الطولية الحالية في الأداء التكيفي عند الرضع الذين تعاني أمهاتهم من الاكتئاب السريري عند عمر 5 أشهر ولكن يتم تحويلهم عند 15 و 24 شهرا. أكملت خمس وخمسون من الأمهات المصابات بالاكتئاب السريري المبكر و132 أخريات لا يعانين من اكتئاب ما بعد الولادة في الولايات المتحدة مقاييس فاينلاند للسلوك التكيفي حول أطفالهن الرضع في عمر 15 و24 شهرًا. بين المجموعات، كانت الأمهات متساويات في العمر والعرق والحالة الاجتماعية والحصيلة اللغوية في المفردات (بديل للذكاء اللغوي)، وكان الرضع متساوين في العمر والجنس. من خلال التحكم في تعليم الأمهات وتكافؤهن، قامت الأمهات المصابات بالاكتئاب السريري المبكر والأمهات اللاتي لا يعانين من اكتئاب ما بعد الولادة بتقييم أطفالهن بشكل مماثل في التواصل ومهارات الحياة اليومية والتنشئة الاجتماعية. الأمهات اللاتي يعانين من اكتئاب سريري مبكر، صنفن أطفالهن على أنهم أفقر في المهارات الحركية. وتم تصنيف الفتيات على أنهن أكثر تقدمًا من الأولاد في التواصل في عمر 24 شهرًا ومهارات الحياة اليومية في عمر 15 و24 شهرًا. زادت مهارات السلوك التكيفي لدى الرضع من 15 إلى 24 شهرًا. مع بعض الاستثناءات، قد يكون الأداء التكيفي عند الرضع قوياً في مرحلة مبكرة من اكتئاب الأمهات، ويمثل الأداء التكيفي مجالًا لتعزيز النمو الإيجابي في هذه الفئة المعرضة للمخاطرة.