Browsing by Author "McCrimmon, Adam"
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Item Open Access An Evaluation of the Efficacy of a Social Intervention in Relation to Social Skills, Cognition, Motivation, and Awareness in Teens with Autism Spectrum Disorder(2017) McCarthy, Laura; McCrimmon, Adam; Wilcox, Gabrielle; McLuckie, AlanThe present study examined social skills, social cognition (SC), social motivation (SM), and social awareness (SA) in teens with Autism Spectrum Disorder (ASD) following the completion of the Program for the Education and Enrichment of Relational Skills (PEERS; Laugeson & Frankel, 2010). PEERS is a caregiver-assisted, evidence-based social skills program that teaches adolescents with ASD foundational skills to make and keep friends effectively. Measures of social skills, SC, SM, and SA were examined one week prior to participation in PEERS (i.e., pre- intervention), one week after PEERS (i.e., post-intervention), and 14 weeks after PEERS (i.e., follow-up). Results revealed no significant changes in social skills after PEERS; however, results indicated significant improvements in SC and SA from pre- to post-intervention, as well as significant improvements in SM from pre-intervention to follow-up. Due to the lack of significant findings in social skill change following PEERS, the study could not investigate predictors of change. Implications of these findings are discussed.Item Open Access An Investigation of Coping Strategies and Mental Health among Peer-Victimized Students with Autism Spectrum Disorder(2017) Altomare, Alyssa; McCrimmon, Adam; Beran, Tanya; Schwartz, Kelly; Strong, TomThe way in which students with Autism Spectrum Disorder (ASD) cope with peer victimization (i.e., bullying) has been relatively unexplored within the literature. Despite the growing number of studies revealing high rates of peer victimization among students with ASD, much is still unknown on how to offset the negative psychological outcomes of this form of abuse. As such, the current study examined coping strategies in relation to anxious and depressive symptoms among peer-victimized students with ASD. Coping strategies were examined using a modified version of Causey and Dubow’s (1992) Self-Report Coping Scale (SRCS; Kochenderfer-Ladd & Skinner, 2002; Wright, Banerjee, Hoek, Rieffe, & Novin, 2010). The sample included 49 students with ASD and intact cognitive functioning, ranging between ages 8 to 17 years (grades 4-12). One parent (n = 48) and one teacher (n = 34) were also invited to participate for each student participant. Consistent with previous research, the results from the current study revealed high rates of peer victimization (using the past month as a timeframe), with the highest rates reported by parents (83.3%) and teachers (73.5%). Examination of coping strategies in relation to mental health among peer-victimized students with ASD revealed that externalizing coping predicted a significant increase in depressive symptoms, whereas trivializing coping (i.e., making light of the problem) predicted a significant decrease in anxiety symptoms. The findings from this study provide important insights into the coping strategies used by students with ASD, as well as suggestions for future research and intervention efforts.Item Open Access Autism in the Context of Humanitarian Emergency: The Lived Experiences of Syrian Refugee Parents of Children on the Autism Spectrum(2021-08-26) Bernier, Abdullah Salahuddin; McCrimmon, Adam; Schroeder, Meadow; Lacerda-Vandenborn, ElisaAutism is a heterogeneous neurodevelopmental condition that varies in severity, presentation, and behavioural expression. Given this heterogeneity and the importance of early intervention, appropriate support, and service is crucial to promote positive outcomes. Research suggests differences in the diagnostic understanding, support acquisition, and service use among diverse, minority, and/or migrant populations. There is a gap in research investigating support and service use among Syrian refugee parents of autistic children in Canada. This study explored the support and service experiences of resettled Syrian refugee parents of autistic children in terms of their pre- and post-migration. These lived experiences were investigated with participants (n = 3) through semi-structured interviews using interpretive phenomenological analysis. This study identified the supports and services parents received, their experiences with those services, their overall experiences with resettlement having an autistic child(ren), the implications of culture in support/service provision, and their perceived areas of service need during and after their resettlement in Alberta, Canada. Parents all had unique experiences that were delineated through clustered emergent themes and subsequently organized into a superordinate conceptual structure. The results of the study are discussed in the context of theory and relevant literature to elucidate and make findings applicable. Practical implications and future directions are discussed.Item Open Access Autistic and Thriving: Self-Defined Thriving of Autistic Adults(2024-08-31) Bicknell, Chelsea J.; McCrimmon, Adam; Andrews, Jac; Makarenko, EricaMuch research on the autism spectrum has focused on causal factors, genetics, effective processes of identification, and approaches to intervention. In contrast, much less has explored positive aspects and outcomes associated with autism, such as thriving; the little work on thriving in the autistic community has primarily used methods of parental and teacher report, limiting the voice of the individuals themselves and leaving a gap in knowledge about how those on the autism spectrum can thrive. As a result, little is known about positive outcomes for autistic individuals and how to promote them. This thesis explored how thriving presents and is defined by autistic adults. This study used the Delphi method to allow autistic individuals to express what thriving is for them. Further, it afforded a consensus on what self-defined thriving is to autistic adults, creating direction and foundational knowledge for future studies to elaborate upon. 19 participants completed a broad, open-ended, online questionnaire regarding what thriving means to them; six additional participants then worked collaboratively to sort and create common themes from the responses to the questionnaire. The findings are discussed in context to existing literature and highlighting new knowledge as well as discussion of research implications and suggestions for future explorations.Item Open Access The Chinese Immigrant Women’s Experience of Autism Diagnosis(2022-06) Ye, Qian Qian; McCrimmon, Adam; Kaori, Wada; Zhao, Xu; McCrimmon, AdamUnderstanding the diagnostic experiences of autistic Canadian Chinese immigrants is imperative for clinical practice in our diverse landscape as they are underrepresented in research and considered vulnerable to delayed care due to their socioeconomic background, immigration status, English proficiency, stigma, and marginalization. Individual experience of the diagnostic process of autistic Chinese immigrants can inform clinicians of how it affects diverse individuals. Data from semi-structured interviews with three Chinese immigrant female participants were analyzed via Interpretive Phenomenological Analysis. Results suggest clinician way-of-being and knowledge about autism were important. Participants preferred a clinician who explained the diagnosis using simple English, rather than jargon, and a use of visual aids was considered helpful. Participants developed a better sense of themselves through the diagnosis but wished there was more awareness about autism, education, and access to supports. Finally, all participants felt more supported when their families were included in the process. Incorporation of these considerations when providing an accessible diagnostic process is encouraged. The implications of these results could inform diagnostic practice guidelines.Item Open Access Cognitive Vulnerability to Depression: A Longitudinal Study using Eye-gaze Tracking to Study Attentional Biases in Never Depressed, Non-Relapsed, and Relapsed Individuals(2016) Newman, Kristin; Sears, Christopher; Dobson, Keith; Pexman, Penelope; McCrimmon, Adam; Carleton, NicholasCognitive models of depression propose that attentional biases are an important cognitive vulnerability in those with a history of depression (e.g., Gotlib & Joormann, 2010; Yiend, 2010; Beck & Haigh, 2014). This study prospectively examined attentional biases in never and previously depressed individuals, who were separated into relapsed and non-relapsed groups. Analyses examined total fixation times, temporal profiles of attention, and prediction of relapse. The evidence from all analyses suggested that attention to positive information is a key vulnerability or resiliency factor related to depression relapse. Specifically, relapsed participants attended to positive images less overall, decreased attention to positive images over the study period, and exhibited significant differences in their temporal profiles of attention for positive images relative to those non-relapsed and never depressed. Less time attending to positive images at the initial visit was predictive of depression relapse, although limited by a small sample size. The attentional biases of the non-relapsed participants reflected both resiliency against and vulnerability to relapse, as they exhibited attentional biases to positive information similar to never depressed participants, but attended to depression-related information more than never depressed participants. Attention to depression-related information was not predictive of depression relapse. Overall, findings indicated that attentional biases to positive information may be most relevant to relapse vulnerability, whereas attentional biases to depression-related information may be more relevant to the maintenance of depressive episodes. The differences observed between relapsed and non-relapsed participants indicate that groups of previously depressed individuals are heterogeneous, which should be taken into account in future research that examines vulnerability to depression. The implications of the study findings are discussed as related to cognitive models of depression and the limitations that may contribute to inconsistent findings in the literature on attentional biases and cognitive vulnerability to depression.Item Open Access Defining A Positive Life Outcome Through Autistic Adult Female Voices: A Qualitative Exploration(2024-09-03) Waller, Madison; McCrimmon, Adam; Shwartz, Kelly; Ellard, John HowardThis study explored the way in which autistic adults conceptualize and define positive life outcomes, and the types of positive life outcomes that are important to them. It also asked autistic adults about what supports and steps may be useful to best support them in acquiring the positive life outcomes they aspire to achieve. Using a qualitative approach, five autistic females over the age of 18 were interviewed through semi-structured interviews. Data was then evaluated using Reflexive Thematic Analysis. Thirteen themes emerged across the three research questions including (1) Societal Understanding and Acceptance of Autism, (2) Personal Achievement, (3) Supports to produce meaningful work, (4) Chasing Passions and Interests, (5) Self-Growth and Wellbeing, (6) Helping Others, (7) Stability, (8) Relationship Happiness, (9) Obtaining Education and Qualifications, (10) Accessible Government Funding and Services, (11) Taking Action: Future Planning, Routine, and Research, (12) Giving and Receiving Social Support, (13) Considerations to Ensure Supports are Collaborative and not Combative. Future research directions and implications for researchers and important stakeholders are discussed in detail.Item Open Access Evaluating the Effectiveness of the Program for the Education and Enrichment of Relational Skills (PEERS) in Relation to Social Skills and Mental Health in Adolescents with High Functioning Autism Spectrum Disorder(2015-11-06) Soares, Melissa; McCrimmon, AdamThe current study investigated the relation between anxiety, depression, social withdrawal and social skills in adolescents with High Functioning Autism Spectrum Disorder (HFASD) who completed the Program for the Education and Enrichment of Relational Skills (PEERS; Laugeson & Frankel, 2010). Anxiety, depression, and social withdrawal were measured across three time point (pre, post, and follow-up). The results indicated that adolescents did not demonstrate significant improvement in socials skills following the completion of PEERS and at a six-month follow-up. Upon further investigation with a median split analysis, the parent-rated “Low social skills group” approached a statistically significant result and the parent rated “High social skills group” demonstrated a decrease in social skills from T2 to T3. Moreover, median split analysis results revealed that the self-reported “High depression group” had a significant decrease in depression symptoms from T1 to T3. No significant improvements were found on social withdrawal or anxiety.Item Open Access Evaluating the Effects of Social Intervention on Social Cognition in Young Adults with High Functioning Autism Spectrum Disorder(2016) Azarkam, Patricia; McCrimmon, Adam; Gabrielle Wilcox, Kelly Dean SchwartzThe current study examined the social cognition of young adults with “high functioning” autism spectrum disorder (HFASD) following the completion of a manualized social skills intervention. The Program for the Education and Enrichment of Relational Skills for Young Adults (PEERS-YA; Laugeson & Frankel, 2015) is a 16-week parent/caregiver-supported, evidence-based, out-patient clinical group intervention designed to help young adults with HFASD develop and maintain lasting friendships. Young adult participants and their parent/caregiver completed formal psychological measures of social skills and social cognition (emotional intelligence and theory of mind) at four time intervals: 1) baseline (3 months before the intervention), 2) pre-test (immediately before the intervention), 3) post-test (one week after the intervention), and 4) follow-up (3 months post-intervention). The results indicate significant improvements in parent-reported social skills and in emotional intelligence at post-test and at follow up, and in theory of mind at post-test. The implications of these findings will be discussed.Item Open Access Examining the Effectiveness of a Social Skill Intervention on Social Skills and Emotional Intelligence in Adolescents with High Functioning Autism Spectrum Disorder(2017) Murphy, Keely Ann; McCrimmon, Adam; Makarenko, Erica; Brandon, JamesThis study examines the relation between social skills and emotional intelligence in adolescents with High Functioning Autism Spectrum Disorder following completion of the Program for the Education and Enrichment of Relational Skills (PEERS; Laugeson & Frankel, 2010). PEERS is a 14-week manualized, caregiver-assisted, evidence-based social skills intervention for adolescents designed to teach the skills required to develop and maintain meaningful relationships. Measures of social skills and emotional intelligence were examined one week prior to participation in PEERS (T1), one week after (T2), and 16 weeks following completion of PEERS (T3). Results indicate significant improvements in social skills and overall emotional intelligence from T1 to T2. A significant positive correlation between social skills and emotional intelligence was found at T1 and T2 for self-report, but caregiver-reported social skills and emotional intelligence were only significant at T1. Additionally, poor reliability of change scores prevented the prediction of social skills from emotional intelligence.Item Open Access Examining the Effectiveness of Social Intervention in Relation to Resiliency, Social Skills, and Mental Health in Young Adults with High Functioning Autism Spectrum Disorder(2016) Coret, Marian; McCrimmon, Adam; Andrews, Jac; Brandon, JimThe present study examined resiliency, mental health, and social skill outcomes in young adults with High Functioning Autism Spectrum Disorder (HFASD) following completion of the Program for the Education and Enrichment of Relational Skills for Young Adults (PEERS-YA; Laugeson & Frankel, 2015). PEERS-YA is a 16-week manualized, evidence based, and caregiver-assisted social skills intervention designed to help young adults with HFASD to develop and maintain relationships. Measures of anxiety, depression, and social skills were examined 16 weeks prior to beginning of the program (T1), one week prior (T2), and one week after completion of PEERS-YA (T3). Additionally, measures of resiliency were examined at T2 and T3. The results indicated significant improvements in parent-reported social skills; however there were no significant improvements in anxiety, depression, resiliency, or self-reported social skills following completion of PEERS-YA.Item Open Access Examining Variables Associated with Successful Treatment Outcomes of Autistic Youth Enrolled in PEERS ©(2021-09) McLeod, Justin; Adam, McCrimmon; Burns, Amy; Makarenko, Erica; McCrimmon, AdamThe present study sought to examine how certain variables of autistic youth who completed a formal social intervention program (PEERS) predicted social skill improvement post intervention. Specifically, this research aimed to determine if age, gender, emotional intelligence (EI), intellectual ability, and/or social cognition would predict social skill outcomes. Using extant data from parent and self-report batteries, change scores and multiple regressions were employed to examine which variables accounted for significant social skill improvement. Age, gender, EI, and social cognition did not predict change; however, higher intellectual ability paired with higher verbal ability and lower perceptual reasoning significantly predicted social skill outcomes for the self-report group. These findings suggest that autistic youth with specific cognitive profiles may be more successful in PEERS. This research also exemplifies the heterogeneous nature of autism symptomology and the continued need for research examining social skill interventions. Limitations and future directions are discussed.Item Open Access The Experience of Receiving a Late Diagnosis for Autistic Young Adults(2021-09) Schembri-Mutch, Taylor; McCrimmon, Adam; Zwiers, Michael; Nicholas, DavidAutism spectrum disorder (ASD) is a neurodevelopmental disorder which presents with deficits in social communication and restricted, repetitive patterns of behaviour. ASD is estimated to occur in 1 in 59 individuals, with the average age at diagnosis being 53 months. Yet, many individuals are missed as children and diagnosed later in life. As a result, adults are now diagnosed more often than youth and/or children. Despite this, little is known about the experience of receiving a late ASD diagnosis. A qualitative inquiry was conducted to better understand the experience of diagnosis and what it is like to be undiagnosed vs. diagnosed with ASD. Eight participants were interviewed and their responses analyzed using interpretive phenomenological analysis. Results identified 29 themes across three different levels. Level 1 themes represented pre-diagnosis and post-diagnosis timeframes and were broken down into Level 2 themes. The pre-diagnosis Level 2 themes were circumstances leading to diagnosis, hidden diagnosis, alternative identities, and potential negative outcomes of not having an ASD diagnosis while the post-diagnosis Level 2 themes were settling into diagnosis, potential benefits of receiving an ASD diagnosis, potential negative outcomes of an ASD diagnosis, and desires. Some Level 2 themes were further broken into more detailed Level 3 themes which communicated the nuances in experiences for each of the participants.Item Open Access Experiences of Autistic Twitch Livestreamers: "I have made easily the most meaningful and impactful relationships"(ACM, 2023-10-22) Mok, Terrance; Tang, Anthony; McCrimmon, Adam; Oehlberg, LoraWe present perspectives from 10 autistic Twitch streamers regarding their experiences as livestreamers and how autism uniquely colors their experiences. Livestreaming offers a social online experience distinct from in-person, face-to-face communication, where autistic people tend to encounter challenges. Our reflexive thematic analysis of interviews with 10 participants showcases autistic livestreamers’ perspectives in their own words. Our findings center on the importance of having streamers establishing connections with other, sharing autistic identities, controlling a space for social interaction, personal growth, and accessibility challenges. In our discussion, we highlight the crucial value of having a medium for autistic representation, as well as design opportunities for streaming platforms to onboard autistic livestreamers and to facilitate livestreamers communication with their audience.Item Open Access Exploring Cognitive Flexibility in Relation to Social Skills and Resiliency in Children with High Functioning Autism Spectrum Disorders(2012-09-24) Altomare, Alyssa; McCrimmon, AdamThe current study examined factors related to resilience in children with a High Functioning Autism Spectrum Disorder (HFASD). Such factors included executive functioning (specifically cognitive flexibility) and social skills. Cognitive flexibility was examined using the Delis-Kaplan Executive Functioning System (D-KEFS), as well as the Behaviour Rating Inventory of Executive Functions (BRIEF). Social skills were examined using the Social Skills Improvement System Parent (SSIS P) and Self-Report (SSIS SR) forms. Resilience was examined via the Resiliency Scales for Children and Adolescents (RSCA). The results indicated that children with HFASD demonstrate greater impairment in cognitive flexibility (as measured by the BRIEF) and social skills (as measured by the SSIS P) in comparison to typical controls; however, there were no significant differences between the two groups on the RSCA. Additionally, a relationship between cognitive flexibility and social skills emerged in the HFASD group.Item Open Access Exploring First Nations Youth’s Strengths and School Engagement(2016) Young, Jenna M.; Schwartz, Kelly; Schwartz, Kelly; Ottmann, Jacqueline; McCrimmon, AdamThe present study examined the positive developmental factors of First Nations youth. Online surveys were administered to 18 First Nations youths to measure their developmental assets (i.e., personal, social, family, school, and community strengths), school engagement (i.e., behavioural, emotional, and cognitive), and cultural identity. Results reveal that middle school students demonstrate higher degrees of all variables measured compared to high school students. Findings also indicate that this sample of First Nations youths possess a relatively low amount of developmental assets. Furthermore, it was found that the more developmental assets this sample of First Nations youth possess, the more they are engaged at school. Lastly, results indicated that school engagement was not related to the First Nations youths’ cultural identity. Interpretations of these findings along with implications, limitations, and suggestions for future research are provided. Keywords: Indigenous youth, First Nations youth, Positive Youth Development, School Engagement, Cultural IdentityItem Open Access Exploring Social Cognition as a Risk Factor for Peer Victimization for Students with Autism Spectrum Disorder(2016) Fenwick, Melanie; McCrimmon, Adam; Brandon, James; Drefs, MichelleIn light of striking prevalence rates and adverse effects of bullying on interpersonal, psychological, and academic functioning, this study investigated a potentially influential risk factor, social cognition, for peer victimization of the uniquely at-risk population of students with Autism Spectrum Disorder (ASD). Two of the most common constructs that comprise social cognition include Theory of Mind (ToM) and Emotional Intelligence (EI). Forty-five students with High Functioning ASD (HFASD) completed measures assessing ToM, EI, and the prevalence and frequency of Bullying. Parent-report was also provided for the measure of bullying. According to student-report, verbal bullying was endorsed most (26.7%), followed by physical (17.8%) and social (15.6%) forms of bullying, while social bullying of student participants was endorsed most by parents (57.8%), followed by verbal (55.6%) and disability (35.6%) forms of bullying. Results indicated that neither ToM or EI predicted the prevalence or frequency of peer victimization for students with HFASD. Research efforts should continue to explore relevant risk factors for students with HFASD to inform policy and program development to effectively support this vulnerable group of students.Item Open Access How Higher Education Leaders, Faculty Members, and Professional Staff can Enhance Services and Outcomes for Autistic Students(2020-11-18) Waisman, Teresia TC; Scott, Shelleyann; McCrimmon, Adam; Zwiers, Michael; Brien, KenThe purpose of this research was to explore how Canadian higher education leaders, faculty members, and professional staff can enhance services and outcomes for Autistic students. This study was situated within the pragmatic paradigm and employed a multilevel, sequential, mixed method design. The mixed methods approach included a total of 111 responses, namely, online questionnaires (n=74) and synchronous or asynchronous, semi-structured interviews (n=37). The sample included a total of 79 participants across four stakeholder groups: university middle level leaders (n=23), faculty members (including two who were themselves Autistic, n=16), professional staff members working with Autistic students in offices such as accessibility services, equity and inclusion services, human rights, or student advocacy (n=10), and Autistic students or individuals who had experienced university studies (n=30). Six major findings emerged from this study: 1. The necessity of inclusive leadership to create the vision and inspire others to enhance services and educational outcomes for Autistic students; 2. The importance of including Autistic voices in the development of relevant, person-centred, outcomes-based autism policies; 3. The necessity of person-centred university policies to adequately attend to the spectrum nature of the Autistic condition; 4. The inclusion of a key strategy – Universal Design for Learning (UDL) and assessments – to ensure genuine and equitable teaching and learning systems that can meet the needs of the greatest number of students, particularly Autistic students; 5. The benefit of campus-wide education about autism led by and/or informed by Autistic individuals to create environmental changes that strengthens a university community’s understanding and acceptance of differences; and 6. The advantage of having Autistic students integrated within higher education communities. The Waisman Model of Best Practice for Autistic Inclusion and Success in Higher Education and a set of recommendations were developed from the findings. This model was designed to provide a pragmatic strategy for leaders to facilitate greater empowerment to all stakeholders, to inform policy and practices, and to innovate teaching, learning, and assessment strategies to benefit all students, but especially those who have unique learning needs, namely, Autistic students.Item Open Access Intervention Perspectives of Public Safety Personnel (PSP) Families(2022-02) Khan, Kaleem; Schwartz, Kelly; McCrimmon, Adam; Makarenko, EricaIn the line of duty, public safety personnel (PSP) experience operational stress that may negatively impact their lives at home. While targeted psychosocial interventions are offered to PSP, research indicates that PSP often turn to their spouse/partners for informal psychosocial support (Carleton et al., 2019). Accordingly, spouse/partners may experience secondary stress related to their PSP partner’s occupation while simultaneously managing their family’s needs. Spouse/partners may benefit from resources and support, although no evidence-based intervention programs are presently offered for their unique needs. For the purposes of informing the development of a PSP family program, the current study collected 131 survey responses (51 female; Mage = 42.57) from both PSP and spouse/partners to explore relative strengths and needs. Exploratory factor analysis revealed three underlying dimensions in survey item responses: Parenting and Communication (F1), Family/Peer Support (F2), and Operational Stress and Resources (F3). Analysis of variance examined differences between factors on several demographic variables, including PSP/PSP spouse, sex, police/non-police, family size (i.e., number of children), and municipality size. Spouse/partners consistently expressed greater intervention needs compared to PSP in F1, F2, and F3 scores; female respondents expressed greater intervention needs compared to male respondents in F1 and F2 scores; no differences were found when comparing police to non-police on any factor scores. Planned comparisons yielded between-group differences based on family size and municipality. Families with no children expressed greater intervention needs compared to families with three or more children in F2 scores. Respondents from towns or smaller municipalities expressed greater intervention needs in F1 and F2 scores compared to those residing in cities. Results are discussed in terms of family systems theory and the available literature on PSP families and similar groups.Item Open Access Limited somatosensory functional connectivity differences in youth with ASD, at rest(2017) Cechmanek, Brian; Bray, Signe; Lebel, Catherine; Dunn, Jeff; McCrimmon, Adam; Barlow, Karen; Curtin, SuzanneChildren and adolescents with autism spectrum disorder typically experience sensory sensitivities, involving over- and/or under-reactions to sensory stimuli. Tactile hyper-reactivity, in particular, is implicated in negative outcomes such as aversion to oral hygiene, dietary issues, and self-harm. Presently, there is no established overarching neurological basis for these sensitivities in autism. Understanding the underlying causes of these sensitivities may help guide pharmacological and behavioural interventions. Motivated by suggested linkages between over-connectivity measures and negative outcomes in ASD, this thesis used resting-state functional-MRI to examine somatosensory functional connectivity differences in youth with autism. Connectivity differences, arising in the somatosensory region, may represent a good marker of sensory sensitivities in ASD. Our findings show limited functional connectivity differences in ASD, and scarce changes in age by diagnosis interaction or autism symptom severity. This suggests that functional connectivity of the somatosensory network in youth with autism is not disrupted, at rest, compared to neurotypical controls.