Alice Sara Carter

University of Massachusetts Boston | UMB · Department of Psychology

Early imitation challenges for children with autism are thought to contribute to broader delays in their social communication development. As such, imitation is an important intervention target for young children with and showing early signs of autism, and efforts are underway to disseminate evidence‐based imitation interventions into community set...

We examined receipt of general early intervention services and autism-specific specialized services across demographic groups among toddlers with autism diagnoses who were receiving Part C Early Intervention (EI). Latent class analysis (n = 508) identified five demographically distinct subgroups associated with intersecting marginalization and priv...

Objective The COVID-19 pandemic required behavioral researchers to rapidly pivot to the implementation of remote study protocols to facilitate data collection. Remote implementation required robust and flexible research protocols including reliable audio/visual technology that met all the quality, security, and privacy hallmarks of lab-based equipm...

COVID-19 required many research teams to shift from in-person to remote assessments, which posed both procedural and theoretical challenges. While research has explored the utility of remote assessments for autism diagnosis from the perspective of families and clinicians, less is known about their application in clinical trials. This paper describe...

Parental representations of the child are linked to positive developmental outcomes in children, but the impact of prenatal representations on early social-emotional development, particularly from fathers, is less understood. This study explores how fathers' and mothers' prenatal representations within two-parent families are associated with early...

Behavioral inhibition and fearfulness in toddlers predict future anxiety disorders. Family-based interventions can prevent and treat anxiety in young children. However, anxiety disorders or their precursors are often untreated until later childhood. This study evaluates a brief caregiver-report measure that may prospectively identify toddlers at ri...

Background/Aims: COVID-19 necessitated a shift to virtual data collection for many research projects, providing the opportunity for novel approaches to carrying out multi-site clinical trials. Virtual multiteam systems (VMTS) are a type of team structure in which multiple geographically dispersed teams collaborate using technology-mediated communic...

We studied the effects of mother–infant interaction and maternal pre- and postnatal psychological distress on children’s social-emotional problems and competences, as well as whether interaction quality moderates the association between distress and children’s outcomes. Maternal pre- and postnatal psychological distress were measured using the SCL...

Background Both child temperament (specifically high shyness and fear) and environmental stressors like the COVID-19 pandemic are known to confer risk for elevated anxiety symptoms in children. However, few studies have examined the long-term impact of the pandemic on young children’s anxiety. Objective We examined the moderating effects of disrup...

This study aimed to replicate and extend findings from the only known study that has conducted latent profile analysis of developmental profiles, measured by the Battelle Developmental Inventory, for children in Early Intervention (EI). Children ( N = 57,966) who were enrolled in Massachusetts EI sites between 2011 and 2019 and completed a Battelle...

Longitudinal research on language abilities and social functioning in young children suggests that gains in one domain affect gains in the other. However, few studies have examined inter-relations of language and social functioning jointly among young children diagnosed with autism spectrum disorder (ASD). Pre-verbal toddlers with ASD are a group o...

Objective: A limited number of studies have estimated the prevalence of emotional-behavioral disorders among young children. None have assessed their co-occurrence with developmental delays using standardized assessment tools. Our objective was to estimate the prevalence of emotional-behavioral disorders and their co-occurrence with developmental...

Objective : To assess changes in screening completion in a diverse, seven-clinic network after making annual screening for social/emotional/behavioral (SEB) problems the standard of care for all infant through late adolescent-aged patients and rolling out a fully automated screening system tied to the electronic medical record and patient portal....

Symptoms of autism influence families’ participation in daily activities, but few studies have broadly explored the types of accommodations caregivers make to their family’s routines after their child is diagnosed with autism. The current study used a mixed-methods approach to characterize the rate and types of accommodations made by 171 families a...

Many parents of toddlers and young children with autism spectrum disorder (ASD) face challenges in identifying community childcare centers that are adequately prepared to provide developmentally appropriate care for their toddler while also obtaining the recommended amount of early intervention services in their communities. Implementing naturalist...

Autistic students often experience peer relationship difficulties. As peer acceptance and rejection may be malleable over time, we examined predictors of change in peer acceptance and peer rejection among early elementary‐age autistic students. We followed 166 autistic children (mean age: 6.1 years [range: 4–8], 82.5% boys, grades preK‐2nd) longitu...

Parents of children diagnosed with autism spectrum disorders (ASD) express concern about raising their children bilingually, and often hear advice from professionals against the use of bilingualism. The current study examined the relation between bilingualism and the language and social communication skills of toddlers diagnosed with ASD (N = 353)...

The U.S. Preventive Services Task Force (USPSTF) report on screening for Autism Spectrum Disorder (ASD) highlighted the need for research that examines the harms potentially associated with screening so as to assess the overall net benefit of universal screening. In response, this study engages qualitative, semi-structured interviews to generate a...

In gezinnen met een kind met een autismespectrumstoornis (ASS) begint ‘de reis’ die ouders maken in het leren begrijpen van het gedrag van hun kind vaak tijdens de screening. Het doel van dit onderzoek was een beeld te krijgen van de interpretatieve processen die daarbij op gang komen. Daarvoor namen we longitudinale interviews af bij 19 gezinnen d...

Lay abstract: Interventions that support social communication include several "components," or parts (e.g. strategies for working with children and families, targeting specific skills). Some of these components may be essential for the intervention to work, while others may be recommended or viewed as helpful but not necessary for the intervention...

Importance The American Academy of Pediatrics recommends referring children at elevated risk of autism spectrum disorder (ASD) for Part C early intervention (EI) services, but notes that EI services often fail to provide ASD screening. Objective To evaluate the hypothesis that a multistage screening protocol for ASD implemented in 3 EI settings wi...

Promoting equity in health services requires an understanding of the mechanisms that produce disparities. Utilizing a sequential, mixed-methods, explanatory study design, we analyzed child-, family-, and organizational-level factors and their association with wait times for an ASD diagnostic evaluation among 353 families scheduled for English and S...

The COVID-19 pandemic has had a profound impact on the lives of individuals, families, and communities around the world with constraints on multiple aspects of daily life. The purpose of the present study was to identify specific profiles of pandemic-related experiences and their relation to psychosocial functioning using the 92-item Epidemic-Pande...

Introduction Studies have shown that many children with early language difficulties also have delays in social-emotional competencies as well as social-emotional and behavioral problems. It is unclear if these conditions are causally related, if they share a common underlying etiology, or if there are bidirectional effects. Studies investigating th...

This research has highlighted a risk for social-emotional and behavioural (SEB) problems in children with developmental language disorder. Associations with delays in social-emotional competencies and language development have been found in both children with language delays and children with language disorders, but findings on the association betw...

The Social Emotional Behavioral (SEB) Team of the National Children's Study (NCS) was tasked with making recommendations for assessment of important aspects of social-emotional health and function in children. This paper describes the constructs recommended for assessment along with the rationale for their assessment. These constructs, representing...

Objectives: This study examined the psychosocial, adaptive behavior , and language outcomes of young children who are hard of hearing (HH) without additional disabilities or neurocognitive impairments. Relations between early developmental outcomes and child and parent demographic variables, and parenting stress and self-efficacy were also explored...

Health disparities in ASD detection affect children’s access to subsequent interventions. We examined potential disparities in implementation of a multi-stage ASD screening and diagnostic evaluation protocol in Part C Early Intervention with 4943 children ages 14–36 months (mean 22.0 months; 62.9% boys, 73.3% children of color, 34.9% non-English-pr...

A family’s journey in understanding their child’s behaviors in relation to Autism Spectrum Disorders (ASD) frequently begins with screening. This study aimed to characterize the interpretive processes that unfold for parents. We employed longitudinal interviews with 19 families engaged in a community-based multi-stage screening protocol. Parents pa...

The COVID-19 pandemic, and associated social distancing mandates, has placed significant limitations on in-person health services, requiring creative solutions for supporting clinicians engaged in the diagnosis of autism spectrum disorder (ASD). This report describes the five virtual instruments available at the time of manuscript development for u...

Objectives: This study examined the psychosocial, adaptive behavior, and language outcomes of young children who are hard of hearing (HH) without additional disabilities or neurocognitive impairments. Relations between early developmental outcomes and child and parent demographic variables, and parenting stress and self-efficacy were also explored...

The aim of this longitudinal study was to investigate early vocabulary development and its relationships with prelinguistic communication skills and social-emotional/behavioral (SEB 1) problems and competencies. The participants were 58 healthy Finnish-speaking children (30 girls, 28 boys). First, the concurrent relationships were investigated at t...

Modern, reliable, and valid outcome measures are essential to understanding the health needs of young children with burn injuries. Burn-specific and age-appropriate legacy assessment tools exist for this population but are hindered by the limitations of existing paper-based instruments. The purpose of this study was to develop item pools comprised...

Five years after the publication of DSM-5 in 2013, three widely used diagnostic instruments have published algorithms designed to represent its (sub-)criteria for Autism Spectrum Disorder (ASD) in children and adolescents. This study aimed to: (1) establish the content validity of these three DSM-5-adapted algorithms, and (2) identify problems with...

Individuals with autism spectrum disorder (ASD) experience differences in visual temporal processing, the part of vision responsible for parsing continuous input into discrete objects and events. Here we investigated temporal processing in 2‐year‐old toddlers diagnosed with ASD and age‐matched typically developing (TD) toddlers. We used a visual se...

To address the paucity of cognitive-behavioral therapy (CBT) protocols available to treat anxiety in preschoolers with ASD, we piloted a family-centered CBT protocol in a series of 16 children aged 3–7 years with ASD and anxiety disorders and explored its feasibility and efficacy. Children were assessed at baseline, post-treatment (PT), and 4-month...

This custom collection consists of important studies, expert recommendations, and practice pathways that inform pediatricians on practical ways to improve the lives of children with ASD and their families. https://shop.aap.org/pediatric-collections-autism-spectrum-disorder-paperback/

This custom collection consists of important studies, expert recommendations, and practice pathways that inform pediatricians on practical ways to improve the lives of children with ASD and their families. https://shop.aap.org/pediatric-collections-autism-spectrum-disorder-paperback/

Determining diagnostic stability of ASD, as well stability of functioning in early childhood, is relevant to prevalence, best practices for communicating early ASD diagnoses to caregivers, families’ experiences, and developmental trajectories. Generalizability of findings from prior research has been limited by small and homogenous samples, short f...

The COVID-19 pandemic has had a profound impact on individuals, families, and communities around the world. Intensive health precautions have created constraints on mobility, work, education, family life, and interpersonal relationships. Preliminary survey studies have reported an increase in the prevalence and severity of psychosocial impairments...

Although the alliance is a consistent predictor of treatment outcomes in psychosocial intervention, few studies have examined this association among youth with autism spectrum disorder (ASD). In particular, youth-therapist alliance has never been examined in social skills interventions (SSI), a common modality for this population. In this study, th...

The language and social skill deficits associated with autism spectrum disorder (ASD) warrant further study. Existing research has focused on the contributions of pragmatic language to social skills, with little attention to other aspects of language. We examined the associations across three language domains (semantics, syntax, and pragmatics) and...

Mounting evidence supports several naturalistic developmental behavioral interventions (NDBI) for toddlers and preschoolers within inclusive childcare centers and preschools. However, these interventions pose many barriers to community implementation. As part of a larger project to create an adapted NDBI for early educators in childcare centers, we...

Introduction: Implementation scientists increasingly recognize that the process of implementation is dynamic, leading to ad hoc modifications that may challenge fidelity in protocol-driven interventions. However, limited attention to ad hoc modifications impairs investigators' ability to develop evidence-based hypotheses about how such modificatio...

Importance Universal developmental screening is widely recommended, yet studies of the accuracy of commonly used questionnaires reveal mixed results, and previous comparisons of these questionnaires are hampered by important methodological differences across studies. Objective To compare the accuracy of 3 developmental screening instruments as sta...

Socioeconomic disadvantage is associated with social-emotional difficulties, including internalizing and externalizing problems, as early as toddlerhood. The aim of the current study was to understand whether economically disadvantaged children's beliefs about the consequences and correlates of poverty (poverty stereotypes) and their beliefs about...

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

We present a consensus-based checklist to improve and document the transparency of research reports in social and behavioural research. An accompanying online application allows users to complete the form and generate a report that they can submit with their manuscript or post to a public repository.

Abstract This study examined an urban school readiness initiative that developed parent leadership as a key strategy for increasing the likelihood that all children enter kindergarten ready to succeed. Parent Leaders were primarily immigrant mothers who conducted outreach activities and child developmental screenings with low income, under-served,...

Objectives Sensitive parenting requires modulation of emotions in order to effectively organize and orient behavioral responses. There is considerable evidence that psychological distress can impair sensitive parenting practices, and also that psychological distress is associated with deficits in emotion regulation capacities. The negative effect t...

Anxiety disorders represent the most common category of psychiatric disorder in children and adolescents and contribute to distress, impairment and dysfunction. Anxiety disorders or their temperamental precursors are often evident in early childhood, and anxiety can impair functioning, even during preschool age and in toddlerhood. A growing number...

Childhood poverty in the U.S. is common and is associated with increased risk for negative outcomes in social-emotional, physical, and academic functioning domains beginning as early as toddlerhood. While research has addressed adults’ negative stereotyped beliefs about people in poverty, little is known about children’s endorsements of stigmatizin...

Background: Young children may be adversely impacted by separation from and loss of caregivers and other loved ones. Such experiences often co-occur with interpersonal violence, unpredictability and other traumas. Whether separation/loss has unique effects independent of those other adversities is not known. Objective: This study aimed to establish...

U.S. guidelines for detecting autism emphasize screening and also incorporate clinical judgment. However, most research focuses on the former. Among 1,654 children participating in a multi-stage screening protocol for autism, we used mixed methods to evaluate: (1) the effectiveness of a clinical decision rule that encouraged further assessment base...

Background and aims: High quality student-teacher relationships (STR) are important for children's academic and social development. We explore how individual child language domains (semantics, syntax, pragmatics), teacher years of experience, and classroom placement (general or special education) relate to STR quality for children with autism spec...

Advances in our understanding of early childhood psychopathology have led to an increase in reliable, valid, and developmentally appropriate rating scales for infants, toddlers, and preschoolers. Caregiver-reported rating scales are helpful to the assessment process because they allow for the standardized gathering of information from the people wh...

The development of executive function is necessary for flexible and voluntary control of behavior. Deficits in executive function are purported to be a primary cause of behavioral inflexibility—a core clinical symptom—in Autism Spectrum Disorder (ASD). Attentional set-shifting has traditionally been measured with the Dimensional Change Card Sort, h...

This study examined if two-year-olds with ASD can update mental representations on the basis of verbal input. In an eye-tracking study, toddlers with ASD and typically-developing nonverbal age-matched controls were exposed to visual or verbal information about a change in a recently encoded scene, followed by an outcome that was either congruent or...

This longitudinal study aimed at showing the effect of early social-emotional/behavioural problems and competencies on vocabulary development in toddlers. The participants were 60 native Finnish-speaking healthy children (30 boys and 30 girls). Parental reports on the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) were gathered at th...

Nearly half of preschool-aged children from low-income families in the United States have been exposed to potentially traumatic events (PTEs), yet few are identified or receive trauma-focused mental health care. Given the critical need to accurately and efficiently identify PTE-exposed individuals, the current study examined discordant caregiver se...

Since 2000, the Autism and Developmental Disabilities Network (ADDM) has published detailed prevalence estimates for autism spectrum disorder (ASD) among 8 year-olds, which are widely interpreted as the U.S. national prevalence of ASD. Although differences in state-level ASD prevalence has been reported, state-level heterogeneity has not been explo...

This study examined if two-year-olds with ASD can update mental representations on the basis of verbal input. In an eye-tracking study, toddlers with ASD and typically-developing nonverbal age-matched controls were exposed to visual or verbal information about a change in a recently encoded scene, followed by an outcome that was either congruent or...

Although it is well-established that young children experience significant psychopathology, diagnostic decisions continue to be challenging, in part due to the way impairment is understood, defined, and measured. Most existing clinical tools assess impairment in an individualized manner, whereas for many young children, impairment is more accuratel...

In 2013, the National Institute of Mental Health funded five trials of unique, multicomponent, systems-based innovations designed to improve access to early screening, diagnosis, and treatment of autism spectrum disorder—collectively known as the Autism Spectrum Disorder Pediatric, Early Detection, Engagement, and Services Network. As part of an on...

Utilizing a two-dimensional model of parenting emphasizing both (1) proximity seeking and (2) exploration, consistent with a conceptual framework rooted in attachment theory, the relations between parental insightfulness, observed parenting, and child cognitive outcomes were investigated in a low-income sample of 64 of caregivers and their young 3–...

Based on limitations in previous research evidence, we concluded that more research is needed for deeper understanding of how social-emotional and behavioral (SEB) outcomes among infant-toddler-aged children in the general population are associated with early motor development. In this study, we investigated associations between early competencies...

This study examined the predictive reasoning abilities of typically developing (TD) infants and 2-year-old children with autism spectrum disorder (ASD) in an eye-tracking paradigm. Participants watched a video of a goal-directed action in which a human actor reached for and grasped one of two objects. At test, the objects switched locations. Across...

This study examined how economically disadvantaged children conceptualize the causes and consequences of poverty. The study sample included 30 children (age 6–9 years) who completed individual interviews. Thematic analysis was used to analyze interview data, beginning with initial codes that were then collated into themes. The following themes emer...

We examined parents’ satisfaction with multiple aspects of their children’s individualized education programs (IEPs). Parents (n = 142) raising children ages 4 to 8 years old with autism spectrum disorder (ASD) reported their satisfaction with four aspects of their children’s IEPs: (a) content of the IEP document, (b) services provided, (c) perceiv...

en Although both mothers and fathers are essential sources of information to address early socioemotional/behavioral (SEB) problems, there continues to be a dearth of studies considering both parental views. A sample of 208 toddlers (Mage = 19.3 months) was recruited through public child health centers. Both parents of 172 toddlers (76 boys, 96 gir...