Wendy L. Stone's research while affiliated with Trinity Washington University and other places

Publications (212)

Article
Lay abstract: The early detection of autism spectrum disorder can lead to access to autism spectrum disorder-specific services that have been shown to have a large impact on a child's overall development. Although a stable diagnosis of autism spectrum disorder can be made by age 2 years, most children are not diagnosed until much later. To address...
Article
This study examined the feasibility of implementing the Screening Tool for Autism in Toddlers, an interactive Level-2 screen for autism spectrum disorder, within Part C Early Intervention settings. Participants included 69 Early Intervention providers (M age = 43.3 years, 93.7% females, 92.4% Whites) from nine programs who attended a one-day Screen...
Article
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...
Article
Family-centered care represents a collaborative partnership between caregivers and service providers, and is associated with positive caregiver and child outcomes. This approach may be especially important for caregivers with early concerns about autism, as service providers are often the gateway to appropriately-specialized intervention. Perceptio...
Article
The COVID-19 pandemic has posed unique challenges for families and caregivers, as well as for autism-focused clinicians, who are faced with providing a thorough and accurate evaluation of children's specific needs and diagnoses in the absence of in-person assessment tools. The shift to telehealth assessments has challenged clinicians to reconsider...
Article
Although symptoms of autism are present early in life and early diagnosis can lead to better outcomes, there is a dearth of validated caregiver-report interviews designed for children under the age of 3 years. We developed the Toddler Autism Symptom Inventory, a semi-structured interview designed to assess the presence and absence of skills and sym...
Article
Despite the development of several evidence‐based Naturalistic Developmental Behavioral Interventions (NDBIs), very few have been adapted for use in community‐based settings. This study examines the implementation of Reciprocal Imitation Training (RIT)—an NDBI—by community Early Intervention (EI; IDEA Part C) providers serving toddlers from birth t...
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Objective: To determine whether an intervention addressing both logistical and knowledge barriers to early screening for autism spectrum disorder (ASD) increases evidence-based screening during 18-month well-child visits and PCPs' perceived self-efficacy in caring for children with ASD. Methods: Forty-six primary care providers (PCPs) from 10 di...
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Lay abstract: Children with autism show more social-communication symptoms and repetitive behaviors than children with typical development or those diagnosed with other developmental disorders; however, non-autistic children often show some behaviors that are associated with autism. We compared the behavioral reports from caregivers of children in...
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Full-text available
Part C early intervention (EI) providers are at the front line of service provision for children under 3 years old with developmental delays or disabilities. As such, they can play a key role in both the early detection of autism spectrum disorder (ASD) and the provision of ASD-specialized treatment. Focus groups were conducted with 25 EI providers...
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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...
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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/
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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/
Chapter
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/
Article
Lay abstract: Later born siblings of children with autism spectrum disorders (ASD) are at elevated risk for language delay or ASD. One way to manage this risk may be for parents to use techniques taught in Improving Parents as Communication Teachers (ImPACT) with the younger siblings during the period in which language delay and ASD may be too sub...
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Lay abstract: In this second of two primary papers, we examined two pre-intervention characteristics that might describe for whom a parent-implemented intervention, "Improving Parents As Communication Teachers," worked. Investigators randomized 97 high-risk siblings and their primary parent to either the Improving Parents As Communication Teachers...
Article
Objective: Most autism spectrum disorder (ASD) screening measures have been developed for use with low-risk (LR) children; however, measures may perform differently in high-risk (HR) younger sibling populations. The current study sought to investigate the performance of an ASD screening measure, the Modified Checklist for Autism in Toddlers, Revis...
Article
Advanced parental age is a well‐replicated risk factor for autism spectrum disorder (ASD), a neurodevelopmental condition with a complex and not well‐defined etiology. We sought to determine parental age associations with ASD‐related outcomes in subjects at high familial risk for ASD. A total of 397 younger siblings of a child with ASD, drawn from...
Article
Background: Long delays between parents' initial concerns about their children's development and a subsequent autism spectrum disorder (ASD) diagnosis are common. Although discussions between parents and providers about early ASD concerns can be difficult, they are critical for initiating early, specialized services. The principles of shared decis...
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Identification of genetic biomarkers associated with autism spectrum disorders (ASDs) could improve recurrence prediction for families with a child with ASD. Here, we describe clinical microarray findings for 253 longitudinally phenotyped ASD families from the Baby Siblings Research Consortium (BSRC), encompassing 288 infant siblings. By age 3, 103...
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Robust findings demonstrate that parents of children with autism spectrum disorder (ASD) experience high levels of parenting stress that are associated with negative outcomes for families. Although the majority of research on parenting stress has focused on parents of children with an existing diagnosis, parents of young children with concerns abou...
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Importance Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with different genetic etiologies. Prospective examination of familial-risk infants informs understanding of developmental trajectories preceding ASD diagnosis, potentially improving early detection. Objective To compare outcomes and trajectories associated with...
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Background: Despite the known benefits of early, specialized intervention for toddlers with Autism Spectrum Disorder (ASD), access to such intervention remains limited. This pragmatic trial examines a novel healthcare delivery model (Screen-Refer-Treat [SRT]), which capitalizes upon existing health care and early intervention (EI) infrastructure t...
Article
Among preschool‐age children with autism spectrum disorder (ASD) and typically developing children, parents' verbal responsiveness (PVR) has long been shown to predict children's later language ability. However, before the age of three, when language develops most rapidly, the early social communication deficits associated with ASD may impact paren...
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Research has identified early appearing differences in gross and fine motor abilities in infants at heightened risk (HR) for autism spectrum disorder (ASD) because they are the younger siblings of children with ASD, and it suggests that such differences may be especially apparent among those HR infants themselves eventually diagnosed with ASD. The...
Article
As the diagnosis and treatment of Autism Spectrum Disorder (ASD) becomes a greater public health concern, access to professionals and expert assessment becomes increasingly more challenging. Novel techniques to improve efficiency of assessment of young children with social communication concerns are desperately needed to address significant barrier...
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OBJECTIVES/SPECIFIC AIMS: Background: Children with autism spectrum disorder (ASD) show a broad range of unusual responses to sensory stimuli and experiences. It has been hypothesized that early differences in sensory responsiveness arise from atypical neural function and produce “cascading effects” on development across a number of domains, impact...
Article
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...
Article
Sensory symptoms, including auditory processing deficits, are common in autism spectrum disorder (ASD). Processing of temporal aspects of auditory input is understudied; yet, deficits in this domain could contribute to language-related impairments. In children with ASD and well-matched controls, this study examined electrophysiological response to...
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Lay summary: This web-based tutorial helped parents of children with ASD use proven strategies to improve their child's participation in daily routines at home. Parents who used the tutorial reported less parenting stress, felt better about their parenting skills, and reported better child social interactions compared to parents who did not use th...
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Altered patterns of sensory responsiveness are a frequently reported feature of Autism Spectrum Disorder (ASD). Younger siblings of individuals with ASD are at a greatly elevated risk of a future diagnosis of ASD, but little is known about the neural basis of sensory responsiveness patterns in this population. Younger siblings (n = 20) of children...
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It has been proposed that early differences in sensory responsiveness arise from atypical neural function and produce cascading effects on development across domains. This longitudinal study prospectively followed infants at heightened risk for autism spectrum disorder (ASD) based on their status as younger siblings of children diagnosed with ASD (...
Article
Lay summary: Sensory symptoms are common in ASD. Temporal processing alterations are often implicated, but understudied. The ability to process rapid sensory information, particularly auditory input, is critical for language functioning. This study tested auditory and visual temporal processing in ASD and controls. Findings suggest that rapid audi...
Article
Parent-reported developmental concerns can be a first step toward further screening and intervention for children at risk for ASD. However, little is known about the extent to which parental well-being and child behavior contribute to parental concerns, especially in families who already have one child with ASD. This study included 54 parents and t...
Article
Children with autism spectrum disorder (ASD) show reduced gaze to social partners. Eye contact during live interactions is often measured using stationary cameras that capture various views of the child, but determining a child’s precise gaze target within another’s face is nearly impossible. This study compared eye gaze coding derived from station...
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The cost associated with incorporating standardized observational assessments and diagnostic interviews in large-scale epidemiologic studies of autism spectrum disorders (ASD) risk factors can be substantial. Streamlined approaches for confirming ASD case status would benefit these studies. We conducted a multi-site, cross-sectional criterion valid...
Article
This study characterized developmental outcomes of a large sample of siblings at familial high-risk of autism spectrum disorder (ASD), who themselves did not have ASD (n = 859), and low-risk controls with no family history of ASD (n = 473). We characterized outcomes at age 3 years using a developmental assessment of language and learning and an obs...
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This study examined how parenting style at 9 months predicts growth in infant social engagement (i.e., social smiling) between 9 and 18 months during a free-play interaction in infants at high (HR-infants) and low (LR-infants) familial risk for autism spectrum disorder (ASD). Results indicated that across all infants, higher levels of maternal resp...
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Messinger et al. found a 3.18 odds ratio of male to female ASD recurrence in 1241 prospectively followed high-risk (HR) siblings. Among high-risk siblings (with and without ASD), as well as among 583 low-risk controls, girls exhibited higher performance on the Mullen Scales of Early Learning, as well as lower restricted and repetitive behavior seve...
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Table of contents Introduction to the 3rd Biennial Conference of the Society for Implementation Research Collaboration: advancing efficient methodologies through team science and community partnerships Cara Lewis, Doyanne Darnell, Suzanne Kerns, Maria Monroe-DeVita, Sara J. Landes, Aaron R. Lyon, Cameo Stanick, Shannon Dorsey, Jill Locke, Brigid Ma...
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Background: Many children with autism spectrum disorder (ASD) demonstrate verbal communication disorders reflected in lower verbal than non-verbal abilities. The present study examined the extent to which this discrepancy is associated with atypical speech sound differentiation. Methods: Differences in the amplitude of auditory event-related pot...
Article
This study used a prospective longitudinal design to examine the early developmental pathways that underlie language growth in infants at high risk ( n = 50) and low risk ( n = 34) for autism spectrum disorder in the first 18 months of life. While motor imitation and responding to joint attention (RJA) have both been found to predict expressive lan...
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Most research into the epidemiology, etiology, clinical manifestations, diagnosis and treatment of autism is based on studies in high income countries. Moreover, within high income countries, individuals of high socioeconomic status are disproportionately represented among participants in autism research. Corresponding disparities in access to auti...
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Early identification of autism spectrum disorder (ASD) is essential to ensure that children can access specialized evidence-based interventions that can help to optimize long-term outcomes. Early identification also helps shorten the stressful "diagnostic odyssey" that many families experience before diagnosis. There have been important advances in...
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This article reviews current evidence for autism spectrum disorder (ASD) screening based on peer-reviewed articles published to December 2013. Screening provides a standardized process to ensure that children are systematically monitored for early signs of ASD to promote earlier diagnosis. The current review indicates that screening in children age...
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Autism spectrum disorders (ASDs) are neurodevelopmental disorders characterized by impaired social communication skills and isolated areas of interest.1 The current prevalence of these disorders is estimated to be 1 in 68, 2 and recent estimates of the risk of recurrence in families with at least 1 child diagnosed with ASD are 10% to 19%.3-5 Advanc...
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This article reviews current evidence for autism spectrum disorder (ASD) interventions for children aged < 3 years, based on peerreviewed articles published up to December 2013. Several groups have adapted treatments initially designed for older, preschool-aged children with ASD, integrating best practice in behavioral teaching methods into a devel...
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The increased male prevalence of autism spectrum disorder (ASD) may be mirrored by the early emergence of sex differences in ASD symptoms and cognitive functioning. The female protective effect hypothesis posits that ASD recurrence and symptoms will be higher among relatives of female probands. This study examined sex differences and sex of proband...
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Positive emotional engagement develops in the context of face-to-face interactions during the first 6 months of life. Deficits in emotional engagement are characteristic of autism spectrum disorder (ASD) and may characterize the younger siblings of children with ASD (high-risk siblings). High-risk siblings are likely to exhibit a broad range of pos...
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Background: The diagnosis of autism spectrum disorder (ASD) made before age 3 has been found to be remarkably stable in clinic- and community-ascertained samples. The stability of an ASD diagnosis in prospectively ascertained samples of infants at risk for ASD due to familial factors has not yet been studied, however. The American Academy of Pedia...
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Although evidence supports the efficacy of early intervention for improving outcomes for children with autism spectrum disorder (ASD), the mechanisms underlying their effectiveness remain poorly understood. This paper reviews the research literature on the neural bases of the early core deficits in ASD and proposes three key features of early inter...
Article
Objective While early brain overgrowth is frequently reported in autism spectrum disorder (ASD), the relationship between ASD and head circumference (HC) is less clear, with inconsistent findings from longitudinal studies that include community controls. Our aim was to examine whether head growth in the first 3 years differed between children with...
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Abstract This investigation illustrates the effects of using different missing data analysis techniques to analyze effects of a parent-implemented treatment on stress in parents of toddlers with autism symptomatology. The analysis approaches yielded similar results when analyzing main effects of the intervention, but different findings for moderati...
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Few behavioral indices of risk for autism spectrum disorders (ASD) are present before 12 months, and potential biomarkers remain largely unexamined. This prospective study of infant siblings of children with ASD (n = 16) and low-risk comparison infants (n = 15) examined group differences in event-related potentials (ERPs) indexing processing of fac...
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Given recent advances in science, policy, and practice of early identification in autism spectrum disorder (ASD), questions about the effectiveness of early intervention have far-reaching service and policy implications. However, rigorous research evaluating the efficacy and effectiveness of intervention programs for toddlers with ASD faces a multi...
Conference Paper
Background: Infant-initiated joint attention (IJA) is the capacity to use gaze and gesture to share awareness of experiences or events with a social partner. This ability typically emerges during the first year of life, and is an important precursor of later social competence. IJA is impaired in children with Autism Spectrum Disorder (ASD) and may...
Conference Paper
Background: Sensory processing abnormalities are amongst the most commonly reported symptoms associated with autism spectrum disorders (ASD), and are now included in diagnostic criteria for ASD in the DSM-V. Auditory processing is a particular area in which both clinical report and experimental evidence indicate atypicalities in ASD, yet much resea...
Conference Paper
Background: Early parent-child interactions play an influential role in shaping children’s social and communicative development, and these interactions may have an even greater impact on the development of children at high risk for developmental challenges (e.g., Landry et al., 2006). One such high risk group is infant siblings of children diagno...
Conference Paper
Background: Individuals with autism spectrum disorders (ASD) exhibit abnormalities in multiple modalities of sensory functioning and in multisensory integration (Iarocci & McDonald, 2006; Rogers & Ozonoff, 2005). For example, utilizing a multisensory “flash-beep” illusion wherein presentation of a single visual flash along with two temporally proxi...
Conference Paper
Background: Many researchers and clinicians have started to utilize the term and concept of a ‘Broader Autism Phenotype (BAP)’ in an attempt to better understand the complex etiology, genetic/familial contributions, developmental trajectories, and range of outcomes associated with siblings of children with Autism Spectrum Disorders (ASD). To use th...
Conference Paper
Given the high autism spectrum disorder (ASD) recurrence risk in younger siblings, it is important to identify early ASD markers within this high-risk population. Although there is increasing evidence that the Modified Checklist for Autism in Toddlers-Revised, with Follow-Up Interview can identify many low-risk children during the second year of li...