Article for Category: ‘Autism Spectrum & Asperger’s’

Heritability of autism spectrum disorders: a meta-analysis of twin studies (Tick et al., 2016)

May 04th, 2016
Journal of Child Psychology and Psychiatry

Journal of Child Psychology and Psychiatry


The etiology of Autism Spectrum Disorder (ASD) has been recently debated due to emerging findings on the importance of shared environmental influences. However, two recent twin studies do not support this and instead re-affirm strong genetic effects on the liability to ASD, a finding consistent with previous reports. This study conducts a systematic review and meta-analysis of all twin studies of ASD published to date and explores the etiology along the continuum of a quantitative measure of ASD.


A PubMed Central, Science Direct, Google Scholar, Web of Knowledge structured search conducted online, to identify all twin studies on ASD published to date. Thirteen primary twin studies were identified, seven were included in the meta-analysis by meeting Systematic Recruitment criterion; correction for selection and ascertainment strategies, and applied prevalences were assessed for these studies. In addition, a quantile DF extremes analysis was carried out on Childhood Autism Spectrum Test scores measured in a population sample of 6,413 twin pairs including affected twins.


The meta-analysis correlations for monozygotic twins (MZ) were almost perfect at .98 (95% Confidence Interval, .96–.99). The dizygotic (DZ) correlation, however, was .53 (95% CI .44–.60) when ASD prevalence rate was set at 5% (in line with the Broad Phenotype of ASD) and increased to .67 (95% CI .61–.72) when applying a prevalence rate of 1%. The meta-analytic heritability estimates were substantial: 64–91%. Shared environmental effects became significant as the prevalence rate decreased from 5–1%: 07–35%. The DF analyses show that for the most part, there is no departure from linearity in heritability.


We demonstrate that: (a) ASD is due to strong genetic effects; (b) shared environmental effects become significant as a function of lower prevalence rate; (c) previously reported significant shared environmental influences are likely a statistical artefact of overinclusion of concordant DZ twins.


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How teenagers with autism interact with typical teenagers in mainstream schools

May 14th, 2013

Transcript of interview with Professor Neil Humphrey of the School of Education at Manchester University about his latest research on how teenagers with autism interact with typical teenagers in mainstream schools.

Presenter: Hello, and welcome to Autism Matters.

Current Government policies stress that children with autism should, if possible, be educated in mainstream schools but is this really best for children with autism?  What difficulties may they face?  How do they interact with typical children and what can teachers and parents do to ensure the best possible outcomes for children with autism in mainstream schools?

I’m very pleased to have Neil Humphrey here with me today to discuss these issues.  Neil is Professor at the School of Education at Manchester University and he’s here to discuss his article published in the July issue of ‘Autism’ entitled ‘Peer interaction patterns amongst adolescents with autistic spectrum disorders in mainstream school settings.’  Neil, welcome to the podcast.

Neil: Thank you.

Presenter: Just to get us started for those who don’t know, can you tell us the difference between a mainstream school and a special needs school?

Neil: A mainstream school is what most parents and listeners will recognise as being the main type of school in this country (the UK).  It’s a school for all children regardless of ability and regardless of any special needs or difficulties that they have.  Specialist schools are schools that have been set up to cater for the needs of particular groups of learners so there are schools, for example, special schools for children with  autistic spectrum disorders where all of the pupils in that school have a diagnosis of ASD and they are staffed with expertise and training in relation to ASD that helps to support those children and young people.

Presenter: So could you just tell us what motivated you to conduct research on the experiences of children with autism in mainstream schools?

Neil: I have a long-standing interest in autism.  I grew up by  friend of the family’s son who’s a couple of years younger than me had very severe autism.  As a younger person, I used to do volunteer work for the National Autistic Society and I also come from a family of teachers who would provide anecdotal examples of children that they taught who had experienced difficulties.

And then as a researcher, I started to look into what the literature said about the experiences of children and found that actually, there was very little research that had been conducted looking at how children with autistic spectrum disorders experience mainstream schools.  And for me, it was really important to find that out because over the last fifteen years, there’s been a big push at the Government level, at the policy level for inclusion wherever possible so that all children, including those with ASD would, where possible, attend mainstream schools.

So I was keen to find out, well, that’s what’s happening on the ground.  More children with ASD are attending mainstream schools than ever before but nobody had really looked at what the experiences of those children and what their outcomes were, so I thought it was an important area to research.

Presenter: Can you tell us a little bit about your research that you’ve just had published in the journal, what you did and why you did it?

Neil: The study that we published in ‘Autism’ this month looks specifically at peer interaction patterns among children with ASD in mainstream schools.  So we had a group of young people with a diagnosis of an ASD.  We have a comparison group of children with other special educational needs, so these are children with reading difficulties in this case, and then we had a second comparison of children with no difficulties or not identified difficulties.

And we had those three groups because we wanted to find out first of all, what differences there were between children with autism and children with no identified difficulties.  But we also, because some of the literature suggested that children with a range of special needs might experience difficulties in mainstream schools, we also wanted to see what was unique about autism and so that’s why we had ‘A.N. Other SEN’ comparison group.

And what we did in this particular study was we were able to observe the children in those three groups at break time and at lunch time over a couple of days, so we had a structured observation schedule from some peer interaction studies that had been done in the United States.  And we observed the children over a two day period, basically focusing on how they interacted with their peers, so what kind of behaviours did they engage in and what behaviours did their peers engage in toward them so that we can get an idea of what kind of social patterns and what social interactions are actually going on in these kind of social settings outside of the classroom.

Presenter: That sounds really interesting.  Can you tell us what you found out?

Neil: Well, what we found which I have to say we did expect, none of it was really particularly surprising, was that first of all the children in the ASD group spent a lot more time on their own.  We expected that, given the nature of autism, but what we also found was that when there were interactions between the children with autism and their peers, they spent much less time engaged in what we had coded as co-operative interaction.

So in children in the other two groups, most of the time was spent talking about things that they do at the weekend or playing games, those kind of co-operative activities.  What we found is there’s much less of that and that actually some of the key differences that emerged were that the children with ASD spent more time engaging in things like reactive aggression.  So they were more likely to lash out at other children having been teased or having been bullied.  They also were subject to more what we called instrumental verbal aggression, so other children coming up to them and saying nasty things to them to try and get a rise out of them. So we found what we felt to be quite a maladaptive pattern of peer interaction.

Presenter: The thing that really struck me from what you’ve just said and from your findings is that everything seems to be very, very negative.  The children were bullied a lot, they engaged in solitary play, they were very aggressive.  Are there any positives of educating children with mainstream schools?

Neil: Yeah, there are.  I think the first thing to say, of course, is that the results that we have with any statistical analysis present the averages, so on average, there are these negative patterns but within the various schools that we visited and the individual pupils that we observed, there were exceptions to that rule.  So there were some schools and some children to whom those patterns didn’t apply but on average, for the group as a whole, they did.

In terms of the benefits of being in a mainstream environment in some of the schools that we worked in, we’ve seen lots of work and preparation that had gone into supporting these pupils so there are many schools where, because there is staff with expertise who are looking out for these children and lots of positive work around peer awareness where these sorts of patterns didn’t occur, it just seems that those schools are not as common as the ones we observed mainly where these children were experiencing difficulties.

In terms of the benefits that can occur in those sorts of schools, the real benefit for young people with autism is being among other children and young people from their immediate neighbourhood and locality, and being able to see models of appropriate social behaviour.  So there is a lot of benefit to be had through attending a mainstream school but what we’ve tended to find is that it needs a lot of work to make sure that the appropriate support is in place.  And unfortunately, the way that things tend to have gone is that the policy outstripped the practice, so schools don’t always feel prepared to support the sorts of young people that we observed.

And some of our other research in the same project actually highlighted that so when we talked to teachers, for example, about their experience of supporting children and young people on the autistic spectrum, quite a few of them felt that they didn’t have the necessary training.  It wasn’t that they didn’t want those children in those schools, it’s just that they felt they needed extra training, they needed extra support to enable them to provide the appropriate provisions for these young people.

Presenter: What else can teachers do to help children with autism in mainstream schools?

Neil: The handful of schools that we saw where there was really good practice, there were systems in place to ensure first of all that all staff who were going to be working with these young people and again, in a secondary school, a young person on the autistic spectrum might have twelve, thirteen, maybe more different teachers, that they all had an awareness of that young person’s needs.

And that necessitated somebody like SENCO, a special needs co-ordinator, providing as much information as possible about what this young person struggles with, what they do well, what sorts of things might make them angry, what sorts of things might make them anxious and so on but also, what sort of adaptations of the everyday practice within the school just to help the young person.  So we kept coming back to this idea that there is very little that we found that was what you would call rocket science, that was something that was out of the ordinary that you hadn’t anticipated.

So some of the schools that worked really well would just make little changes, so we knew from speaking to the young people that they found moving from one lesson to another quite an anxiety provoking experience because it’s lots of large crowds of young people all rushing into different places all at once in quite a cramped environment and a lot of the young people we spoke to found that quite anxiety provoking.

So the schools where there was good practice, they’d made little changes.  The young person with autism might be allowed to leave a lesson a couple of minutes early so that they could get to their next destination before that big rush occurs.  Use of visual timetables or increased use of visual timetables to help young people in the classroom understand the structure of the lesson or changes when teachers were off sick and there would be a supply teacher come in, that kind of change in routine might be quite difficult for a young person with Asperger’s or autism because it’s a big change in routine.

So the school would make sure that they’d done lots of preparation with that young person on the morning to say, “It’s not going to be Mrs Smith for English today.  It’s going to be another teacher,” and then they would also make sure that supply teacher knew there was a young person with an ASD in the classroom so that they knew they might have to make some adaptations.

So these were all relatively simple adaptations that any school could make, but it’s making sure that there is somebody in that school who is actually driving those adaptations so in each of the schools where there was good practice there was always a central person, usually the SENCO, the special needs co-ordinator who was really passionate about autism, really knowledgeable and she was making sure these sorts of things happened so that the young people’s needs were being met.

Presenter: I suppose parents would have a role to play here as well, wouldn’t they?

Neil: Absolutely.  The other kind of key thing that enabled some of the schools to do really good work with the children was the information that parents were able to provide because the parents obviously know their child better than anyone.  And so a lot of the information about the child’s needs would come directly from the parents so again, in the schools where there was good practice, there were really strong relationships with parents and really regular contact so that parents could pass on information, even if it was on a daily basis, “Look, he’s in a really bad mood today.  Something’s thrown him at home and you might find it quite difficult to deal with him.”

Those little bits of updates of information about what the school could do to help that young person were really important in making sure that their needs would be met.

Presenter: What would your advice be to parents who are currently debating whether their child would fare better in a mainstream school or a special needs school?

Neil: Well, it’s a really difficult decision.  I think the key thing is the status quo is such that most young people with an autistic spectrum disorder now will attend a mainstream school and a smaller proportion will end up in specialist provision.  The parents who are looking at where might be best for their child, the advice I would give really is about knowing not all mainstream schools are the same.  Part of the decision process is going to be about looking at what’s the provision like in the school that my child might go to, particularly at the secondary level which was where we were interested in our study.  We looked at secondary schools because I think it’s particularly secondary school where things become quite difficult socially for children and young people on the autistic spectrum.

So it’s actually doing the homework around what sort of provision is set up in the school, going and speaking to the school and particularly the special needs co-ordinator within the school and finding out what sorts of provision have they got in place to support young people on the autistic spectrum.  Some mainstream schools, for example, have a resourced unit so within the mainstream school there is a resourced environment where children and young people on the autistic spectrum can have some of their lessons so they’re not always out in the mainstream for the entire time.

So it’s finding out whether those sorts of things are in place in their local school and talking to education professionals, people like educational psychologists and other people that might be involved in arranging provision to find out what’s going to be in their child’s best interests.  And in a lot of cases, that will be mainstream education but I think it’s important to acknowledge as well that some children’s needs are met more appropriately in specialist provision.  So having a range of provision in each locality is important as well but obviously that’s not always the case.  It depends on where you are in the country.

Presenter: Just to finish off now, in one sentence if you can, what would you say is the take home message for the listeners of the podcast?

Neil: I guess the take home message would be our research has demonstrated that on average, there are some negative things that happen between children with autism and their peers in these mainstream settings.  But that by no means means that all children and young people with an ASD are going to experience those sorts of difficulties.  So it’s not just simply a case of special is better than mainstream or mainstream’s better than special.  It’s more about trying to look at what’s the experience like for young people and how can it be improved.


For help with autism and Asperger’s Syndrome on the Gold Coast and in the Tweed region contact Understanding Minds.

Like us on Facebook for updates on autism spectrum related matters, information on other developmental disorders like dyslexia, language and communication problems, and ADHD, as well as general mental health info.






[End of recorded material]

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Autism & Asperger’s Syndrome article in Gold Coast kids magazine

March 07th, 2013

Article on autism spectrum conditions (autism and Asperger’s Syndrome) in the Gold Coast kids mag Coast Kids GC.

Mind Matters_autism

Click on the link above. Another screen will open. Click on the file name again to download the file. 


For help with autism and Asperger’s Syndrome on the Gold Coast and in the Tweed region contact Understanding Minds.

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The unique qualities of girls and women who have Asperger’s and autism

February 19th, 2013

The male to female ratio for Asperger’s syndrome is 4:1. This means that most clinicians (and a lot of research data) are biased towards the ways in which boys present.

Click here to listen to Professor Tony Attwood talk about the unique qualities of girls who have autism spectrum conditions. 

For help with autism and Asperger’s Syndrome on the Gold Coast and in the Tweed region contact Understanding Minds.

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Autism & Asperger’s article free in Autism Research

February 06th, 2013

The 5 most downloaded articles in the journal Autism Research are available for a limited time.

Global Prevalence of Autism and Other Pervasive Developmental Disorders

Independent and dependent contributions of advanced maternal and paternal ages to autism risk 

Self-other relations in social development and autism: multiple roles for mirror neurons and other brain bases

Genes related to sex steroids, neural growth, and social-emotional behavior are associated with autistic traits, empathy, and Asperger syndrome 

Assessing autistic traits: cross-cultural validation of the social responsiveness scale (SRS) 


For help with autism and Asperger’s Syndrome on the Gold Coast and in the Tweed region contact Understanding Minds.


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