Editorial

Welcome to the second edition of 2018. This issue features papers from a range of stakeholder perspectives.

The first paper by Chester et al. is one of the first to examine the clinical challenges associated with a diagnosis of psychosis in individuals with autism spectrum disorder (ASD), and intellectual disability (ID) using a case series approach. It is generally accepted that early identification and treatment is essential to reduce impact on both present and future quality of life. This case series examines four patients with psychosis, ASD and ID, who have been in receipt of forensic mental health and ID services. In all cases, the use of antipsychotic medication was associated with an improvement in both psychotic symptoms and quality of life. ASD symptoms that were exacerbated as part of the psychosis also fell back to the levels they were pre psychosis.

The second paper from Adamou et al. examines gender differences in autism, which are still poorly understood. Our first paper based in an NHS specialist service for ASD. This study examines the assessment process retrospectively, specifically for significant gender differences. Using the ADOS scores of patients referred, the study results provide support that autism diagnostic tools have a gender bias towards a traditional male presentation of autism. With women females reportedly under diagnosis, this paper adds evidence to support the move for diagnostic tools to be developed to address this bias.

The third paper from Razaei et al. investigated the effects of combined risperidone (RIS) and pivotal response treatment (PRT) in children with ASD. Using the child communication checklist (CCC), two groups, namely, an RIS treatment group and an RIS plus PRT, were compared. In both groups, the total score of the CCC improved and the authors concluded that treatment with RIS combined with PRT may result in a better outcome in communication skill for children with autism than RIS training alone.

The fourth paper from Tolchard and Stuhlmiller describes the evaluation of health and behavioural lifestyle outcomes of people diagnosed with ASD in a student-led clinic in rural/regional Australia. Although it is generally accepted that people with ASD are at greater risk of developing chronic health through lifestyle choices and problems, there are few studies that examine people living in rural communities in cultural backgrounds traditionally underserved by healthcare services. This paper confirmed an increased risk for people with ASD developing chronic conditions when compared to the general population and dominant culture. Evidence included higher BMI and blood sugar levels and anxiety disorders. In terms of lifestyle, smoking was an issue for people with ASD but there was not an increased risk of alcohol use. The paper not only gives an insight into ASD in a rural community, but it also offers an insight and solutions into how services can respond and adapt or modify care for people with ASD to improve health outcomes.

The final paper from Kannis-Dymand et al. examines metacognitive beliefs and processes in children and associations with anxiety and depression. In the general population, metacognitive beliefs have been found to maintain perpetuate symptoms of anxiety and depression. However, the association of metacognitive beliefs in children with ASD is still unclear. This area has attracted limited research attention, and this study offers an insight into the role of metacognitive beliefs in high functioning children with ASD and comorbid anxiety or low mood and future targets for research.

We hope you enjoy this edition of the journal and wish to thank you for your continuing support of Advances in Autism. We invite contributions from our readers to the journal and welcome a variety of papers on areas including innovative and evidence-based practice, research, case studies, service and policy-related issues and literature reviews. We welcome submissions from the range of health and social care professionals, but additionally those who use services and people who care for them. If you would like to know more about how to submit your work for publication, please contact us at: chapline@lsbu.ac.uk