Anat Zaidman-Zait

This Response addresses a Letter to the Editor by Sahin ( Child and Adolescent Mental Health , 2026) concerning our network analysis of autism characteristics and anxiety symptoms in autistic children and youth ( Child and Adolescent Mental Health , 2025, 30 , 327). In his Letter, Sahin proposes three extensions for future research: examining whether Theory of Mind mediates the association between social communication and anxiety, modeling intolerance of uncertainty and arousal dysregulation as potential bridge mechanisms, and estimating comparable network models using autistic youths' self‐report data. In this Response, I argue that although each extension warrants further examination, it also raises conceptual and methodological issues that require closer consideration. Moreover, I emphasize that examining potentially modifiable mechanisms underlying autism–anxiety co‐occurrence will require future research to move beyond descriptions of cross‐sectional network topology and adopt study designs and network models better suited to examining temporal and mechanistic processes.

Guided by a lifespan developmental perspective, using a network analysis approach, this study compared the structure of daily stress components in mothers of adolescents and adults with developmental disabilities (DD) and a matched sample of mothers of children without DD. We also examined whether components of daily stress were differentially associated with subsequent depression symptoms. Participants ( N = 516; 100% female; M = 54.52 years, SD = 10.21; 94.2% White) were drawn from two cohorts: a DD cohort constructed from two linked longitudinal studies of families of adolescents and adults with autism and fragile X syndrome and a comparison group from the Midlife in United States study. Participants completed an 8-day daily telephone interview and reported depressive symptoms two years later. Findings demonstrated that the daily stress network of mothers of individuals with DD was significantly more interconnected than that of the comparison group. Stressor risk appraisal emerged as a central node in both groups, highlighting the role of cognitive appraisal in shaping stress responses. Negative affective reactivity linked daily stress components with later depressive symptoms, particularly in the DD group. Chronic caregiving stress may heighten interconnectivity within daily stress networks, reducing psychological flexibility and increasing vulnerability to daily stressors.

This Response addresses methodological and conceptual issues raised in a Letter to the Editor concerning our recently published network analysis of autism characteristics and anxiety symptoms in autistic children and youth. We clarify concerns related to potential conceptual overlap between autistic characteristics and anxiety‐related symptoms and address questions concerning the multinational nature of the dataset. We also summarize sensitivity and stability analyses showing that the identified bridge nodes are robust to variation in regularization parameters and operational definitions. Together, these clarifications support the interpretation of the reported network findings.

Clinical guidelines recommend collecting reports from multiple informants when identifying and diagnosing challenges in children. The current study examined parent–teacher discrepancies in rating of autistic children’s adaptive functioning and how these related to children’s executive functions. Participants ( n = 194) were a subsample of autistic children (mean age = 9.2 years; 86% male) from the Pathways in ASD cohort. We used latent profile analysis to characterise profiles based on both parent and teacher reports of adaptive functioning levels. We tested links between these profiles and indices of children’s executive function and other clinical correlates. Four profiles were characterised: a lower adaptive functioning-parent higher profile, in which parents reported relatively higher scores than teachers ( n = 45), an intermediate adaptive functioning profile ( n = 70) and a higher adaptive functioning profile ( n = 39; both characterised by similar ratings between informants) and finally, a higher adaptive functioning-teacher higher profile, in which teachers reported relatively higher scores than parents ( n = 40). The higher adaptive functioning-teacher higher profile showed fewer teacher-rated executive function challenges and higher IQ compared to the other profiles. Characterising profiles facilitates interpretation of informant discrepancies and identification of clinical correlates to inform clinical decision-making. Lay Clinicians are advised to collect reports from multiple informants (e.g., parents and teachers), when making assessments about the wellbeing of autistic children. Parents and teachers observe children in different environments (home vs. school); therefore, collecting both reports can give a fuller account of a child’s strengths and challenges. In this investigation, we looked at parent and teacher reports of autistic children’s adaptive functioning, an important body of skills necessary for children to navigate daily life including practical, communication and conceptual skills. Currently, we know little about child characteristics associated with informant discrepancies, which means that it is a challenge to identify which children are most likely to display behaviour differently across contexts. We grouped n = 194 children based on the level of adaptive functioning reported by both their parent and teachers, and we compared the groups on key characteristics. We identified four groups: a lower adaptive functioning group with higher parent scores ( n = 45), an intermediate group with similar scores from both informants ( n = 70), a higher adaptive functioning group with similar scores from both informants ( n = 39) and a higher adaptive functioning group with higher teacher scores ( n = 40). Our findings indicate that many children display adaptive functioning skills differently across contexts, across levels of adaptive functioning skills. We found that children across groups differed on IQ, autistic traits and teacher-rated executive functioning. These findings can help clinicians identify and evaluate autistic children that might be likely to demonstrate different adaptive functioning skills in different environments, which could help with assessment and treatment planning.

Background: Autistic children experience significantly higher rates of anxiety compared to nonautistic children. The precise relations between autism characteristics and anxiety symptoms remain unclear in this population. Previous work has explored associations at the domain level, which involve examining broad categories or clusters of symptoms, rather than the relationships between specific symptoms and/or individual characteristics. We addressed this gap by taking a network approach to understand the shared structure of autism characteristics and anxiety symptoms. Method: Data were pooled from five studies from Canada, Singapore, the UK, and the USA, totaling 623 autistic children (17% female sex; aged 6–18 years), for whom the parent‐report Spence Children's Anxiety Scale (SCAS‐P) was available. We derived two undirected regularized networks, first from the SCAS‐P items only, and then by adding autism characteristics pertaining to social communication, highly focused and repetitive behavior, and sensory hypersensitivity. From these models' metrics, we extracted nodes' predictability, key bridging nodes, and community detection. Results: The anxiety‐only network was highly connected and consisted of four key clusters: General Anxiety, Social Anxiety, Separation Anxiety, and Panic/Agoraphobia. These broadly aligned with the existing SCAS‐P structure based on DSM‐IV‐TR criteria. In the autism‐anxiety network, the structure of anxiety remained mostly stable, with autism features forming their own community. Preference for predictability (i.e., sameness) and sensory hypersensitivity were key nodes that linked autistic features and anxiety symptoms, primarily through generalized anxiety. Conclusion: This study identified some of the key characteristics that bridge the broadly independent structures of autism characteristics and anxiety symptoms. The findings are discussed in the context of guiding the assessment, prevention, and treatment of anxiety in autism.

Assessing autistic traits alongside co‐occurring emotional/behavioral concerns (EBCs) is challenging due to their overlap in clinical presentations, which can vary by age and sex. This study aimed to investigate domain‐specific associations between autistic traits and EBCs–including anxiety, affective, attention‐deficit/hyperactivity, and oppositional‐defiant problems–across childhood in autistic boys and girls. We prospectively followed 389 children (84% male) diagnosed with autism at ages 2–5 years, using the Social Responsiveness Scale (SRS) and Child Behavior Checklist (CBCL) across eight timepoints until age 12. Moderated nonlinear factor analysis was used to identify and adjust for measurement non‐invariance of SRS items by age, sex, and EBCs. The adjusted scores were then used for sex‐moderated time‐varying modeling of associations between autistic traits and EBCs. Several SRS items in the domains of social‐interaction difficulties and repetitive mannerisms showed significant intercept bias by age and level of co‐occurring anxiety and ADHD (effect size r > 0.20). In autistic boys, strong associations were observed between social‐communication difficulties and EBCs around ages 7–9, which tended to diminish in late childhood. In contrast, autistic girls showed stable or intensifying associations, particularly with anxiety, into late childhood. Results revealed significant associations between autistic traits and EBCs after addressing item‐level measurement biases. The varying associations over time highlight the importance of continuous monitoring to promptly address autistic children's sex‐differential mental health needs. These findings emphasize the benefits of refining behavioral constructs and adopting a nuanced developmental approach to identify critical periods of symptom coupling/decoupling for informing evaluation and service provision.

Anxiety has been associated with social communication and interaction differences among autistic children. We sought to clarify the direction of these associations longitudinally, and test executive function as a moderator. Participants were autistic children ( N = 157; 15% female, 85% male) engaged in a longitudinal study. Analyses focused on two timepoints during preadolescence ( M ages 9.7 and 10.7 years). A cross-lagged panel model tested whether parent-reported anxiety at age 9 years predicted teacher-reported social communication and interaction differences at age 10 years, and vice versa. Next, multigroup analyses tested for similarity in cross-lagged pathways at different levels of teacher-reported metacognition and behavioural regulation (two facets of executive function). At each time point, respectively, 22% and 21% of children had anxiety exceeding a suggested clinical threshold. Longitudinal associations between parent-reported anxiety and teacher-reported social communication and interaction differences were not significant in the full sample. However, multigroup analyses found lower levels of parent-reported anxiety at age 9 years predicted greater teacher-reported social communication and interaction differences at age 10 years among participants with clinically elevated behavioural dysregulation. Findings indicate low levels of anxiety, coupled with behavioural dysregulation, may signify potential for increasing social communication and interaction differences observed by teachers among autistic children entering adolescence. Lay Anxiety is a mental health concern affecting many autistic children, and has been linked to greater differences in social communication and interaction style. Executive functioning (i.e. the ability to direct and regulate attention and behaviour) plays an important role in autistic children’s social–emotional development. We tested whether anxiety (reported by parents) predicts social communication and interaction differences (reported by teachers) over time or vice versa among autistic preadolescents. We also investigated whether the link between anxiety and social communication and interaction differed depending on children’s EF abilities (reported by teachers). We found less parent-reported anxiety predicted more teacher-reported social communication and interaction differences a year later – but only for children who had heightened behavioural dysregulation (an aspect of executive functioning that includes impulse and emotion control). Our work suggests autistic preadolescents with behavioural dysregulation and limited anxiety may be at greater risk for social difficulties, and may need more support in this area. Executive functioning may be a useful mechanism to target in treatment for this group of children.