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Characteristics and Anxiety Symptom Presentation Associated
with Autism Spectrum Traits in Youth with Anxiety Disorders
Cara A. Settipania, Connor M. Puleoa, Bradley T. Connera, and Philip C. Kendalla
aDepartment of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA 19122,
United States
There is limited information about the nature of anxiety among youth with symptoms of autism
spectrum disorder (ASD). The present study examined (a) differences in the clinical characteristics
of anxious youth with and without symptoms of ASD and (b) the symptoms of anxiety that best
distinguish between these groups. Results indicated that anxious youth with elevated ASD
symptoms had significantly more diagnoses (e.g., specific phobias), and were more likely to meet
diagnostic criteria for social phobia (and list social concerns among their top fears) than youth
without elevated ASD symptoms. At the symptom level, severity of interpersonal worry based on
parent report and severity of fear of medical (doctor/dentist) visits based on youth report best
differentiated ASD status. The findings inform diagnostic evaluations, case conceptualization, and
treatment planning for youth with anxiety disorders and ASD symptoms.
child anxiety disorders; autism spectrum disorders; comorbidity; anxiety symptoms; distinguishing
1. Introduction
Anxiety is among the most common psychopathologies in childhood, with prevalence rates
ranging from approximately 3% to 24% in community samples (see Cartwright-Hatton,
McNicol, & Doubleday, 2006 for a review) and varying from 5.7% to as high as 57.7%
among youth in clinical settings (e.g., Esbjørn, Hoeyer, Dyrborg, Leth, & Kendall, 2010;
Hammerness et al., 2008; Weiss & Last, 2001). A recent study on lifetime prevalence of
mental disorders among adolescents in the United States indicated that nearly 1 in 3
adolescents met criteria for an anxiety disorder (Merikangas et al., 2010). Autism spectrum
disorders (ASDs), which are characterized by deficits in social interaction and
communication, and the presence of restricted interests or stereotyped behavior (American
Psychiatric Association, 2000), are one of the more common, serious developmental
disabilities, affecting as many as 1 in 91 children (1 in 58 boys) in the United States (Centers
for Disease Control and Prevention, 2007; Fombonne, 2005; Kogan et al., 2009). Research
© 2012 Elsevier Ltd. All rights reserved.
Correspondence concerning this article should be addressed to Cara Settipani, Department of Psychology, Temple University, 1701 N.
13th Street, Philadelphia, PA 19122, United States. firstname.lastname@example.com; Tel: +1 215 204 7165; Fax: +1 215 204 0565.
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J Anxiety Disord. Author manuscript; available in PMC 2013 April 1.
Published in final edited form as:
J Anxiety Disord. 2012 April ; 26(3): 459–467. doi:10.1016/j.janxdis.2012.01.010.
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suggests anxiety and ASD often co-occur: anxiety is substantially more common among
children with ASD relative to their typically developing peers (e.g., Bellini, 2004;
Guttmann-Steinmetz, Gadow, DeVincent, & Crowell, 2010; Russell & Sofronoff, 2005).
Approximately 42-55% of youth with ASD meet criteria for an anxiety disorder (White,
Oswald, Ollendick, & Scahill, 2009) and as many as 62% of youth with mood or anxiety
disorders show elevated autism spectrum traits (Constantino et al., 2006; Pine, Guyer,
Goldwin, Towbin, & Leibenluft, 2008; Towbin, Pradella, Gorrindo, Pine, & Leibenluft,
Although anxiety symptoms have been observed across the full spectrum of autism
impairment, they may be particularly pronounced in youth with milder ASDs. Several
studies suggest that children with Asperger's syndrome and pervasive developmental
disorder-not otherwise specified (PDD-NOS), ASDs characterized by higher adaptive
functioning and less cognitive impairment, may experience greater anxiety than more
severely affected children (Muris, Steerneman, Merckelbach, Holdrinet, & Meesters, 1998;
Thede & Coolidge, 2007; Weisbrot, Gadow, DeVincent, & Pomeroy, 2005). Given evidence
that higher functioning youth with ASD often experience distressing symptoms of anxiety,
along with research suggesting that ASD symptoms are continuously distributed in the
general population (Constantino & Todd, 2003), it is likely that a substantial number of
children who present for treatment of anxiety disorders will also exhibit ASD traits that may
influence their responsiveness to treatment (e.g., Puleo & Kendall, 2011).
Studies have explored anxiety in children with ASD (see Puleo & Kendall, 2012 and White
et al., 2009 for reviews), with anxiety-related concerns identified as one of the most
common presenting problems for youth with ASD in clinical settings (Ghaziuddin, 2002),
but few have considered the prevalence and ramifications of subthreshold autism spectrum
symptoms in children with anxiety disorders. When they have been examined, autism
spectrum symptoms have typically been measured in mixed samples, including children
with anxiety, bipolar disorder and depression (e.g., Towbin et al., 2005), or an even broader
range of non-ASD psychiatric conditions (Constantino et al., 2006). Though these studies
suggest that children with non-ASD psychopathology may still demonstrate elevated autism
spectrum symptoms, the specific relationship between anxiety disorders and autism
spectrum symptoms remains unclear. Few studies have assessed the prevalence of these
features in youth with principal anxiety disorders (as opposed to general psychopathology),
and none have considered the presentation of anxiety in these youth (Constantino et al.,
2006). Rather, such questions have previously been limited to studies of anxiety in children
who meet full diagnostic criteria for ASD.
Questions remain regarding the nature, expression, and diagnostic classification of anxiety
in children with ASD (Puleo & Kendall, 2012, White et al., 2009; Wood & Gadow, 2010),
as both ASD and deficits associated with ASD may influence the presentation of anxiety.
Wood and Gadow (2010) proposed that core ASD symptoms can lead to stressful
experiences that generate anxiety. Expression of ASD symptoms, such as preferences to
engage in preferred routines, or sensory sensitivities, may conflict with social expectations
and lead to negative reactions from others (Bellini, 2004; 2006; Gillott & Standen, 2007;
Goodwin, Groden, Velicer, & Diller, 2007). Social interactions may be particularly
confusing and unpredictable to individuals with ASD who struggle to understand and
anticipate the emotional states and intentions of others (e.g., Baron-Cohen, Leslie, & Frith,
1985; Baron-Cohen & Wheelwright, 2004; Demurie, De Corel, & Roeyers, 2011). Given the
special stressors experienced by youth with ASD, the presentation of anxiety among these
youth may differ from that of their typically developing peers, and such differences may also
be apparent in anxious youth with subthreshold ASD features. Although the current study
explores subthreshold ASD symptoms among youth with a principal anxiety disorder, the
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literature available for review largely focused on youth who meet full diagnostic criteria for
1.1. Anxiety Presentation Among Youth with ASD
Research on anxiety in children with ASD may guide hypotheses regarding the clinical
presentations of anxious youth with ASD features. Previous studies suggest that ASD
children may show a different pattern of anxiety than anxious youth without ASD. Children
with ASD meet diagnostic criteria for specific phobias (e.g., Mattila et al., 2010;
Sukhodolsky et al., 2008) at a substantially higher rate than the 3.5-7.9% prevalence
reported in community samples (e.g., Essau, Conradt, & Petermann, 2000; Kim et al., 2010).
Research also suggests variation in the frequency of particular types of specific phobias.
Children with ASD have been found to have more parent-reported physical injury fears
compared to typically developing anxious youth, a pattern that may be explained by a
heightened sensitivity to noise and touch among youth with ASD (Russell & Sofronoff,
2005). When compared to youth with Down Syndrome, mentally age-matched children, and
chronologically age-matched children, ASD youth were more fearful of specific situations
and had more medical fears based on parent-reports (Evans, Canavera, Kleinpeter,
Maccubbin, & Taga, 2005). Leyfer and colleagues (2006) found that the most common
DSM-IV lifetime diagnosis in their sample of ASD children was specific phobia, with 44%
meeting diagnostic criteria. They also reported fear of needles and/or shots and crowds as
the most common specific phobias, whereas phobias typically observed among children in
the general population (e.g., fears of flying, bridges, tunnels) occurred at very low rates,
again suggesting a different presentation of specific phobias among ASD youth. In addition,
more than 10% of youth with ASD in the Leyfer et al. (2006) study met criteria for a
specific phobia of loud noises. Given that heightened sensitivity to environmental
stimulation and difficulties in sensory modulation are related to anxiety in individuals with
ASD (Green & Ben-Sasson, 2010; Pfeiffer Kinnealey, Reed, & Herzberg, 2005), it is not
surprising that specific phobias involving adverse sensory stimulation more commonly arise
among these youth. Differences in the somatic expression and severity of anxiety in ASD
youth have also been noted, with some studies suggesting that ASD youth display more
difficulty controlling their worries and more severe overall anxiety, despite fewer
physiological symptoms of anxiety (Helverschou & Martinsen, 2011; Russell & Sofronoff,
2005; Weisbrot et al., 2005).
Research on social phobia among ASD youth has yielded mixed results, and studying
characteristics of ASD within anxiety disorders may add clarification. Some studies suggest
social concerns are among the more common sources of anxiety for children with ASD
(Farrugia & Hudson, 2006; Sukhodolsky et al., 2008; Weisbrot et al., 2005), and it has been
speculated that social phobia may be particularly prevalent in ASD youth with higher
cognitive abilities given the substantial social impairments inherent to ASDs (Attwood,
2000). However, other research suggests that diagnosis of social phobia among ASD youth
may be primarily based on avoidance of social situations rather than interpersonal concerns
per se (Leyfer et al., 2006). It is unclear whether the lower rate of friendships among
individuals with ASD is due to a lack of desire for social relationships or deficits in skills
needed to form and maintain these relationships (Mesibov, Schopler, Schaffer, & Michal,
1989; Orsmond, Krauss, & Seltzer, 2004; Rutter, 1970), a confusion that may also
complicate social phobia diagnosis in youth with ASD symptoms. Though it is sometimes
assumed that youth with ASD prefer not to engage in social interactions, many individuals
with ASD are acutely aware of and distressed by their social difficulties (Attwood, 2000).
High functioning ASD youth have been found to report more social worries and social
anxiety (Burnette et al., 2005; Gillott, Furniss, & Walter, 2001; Kuusikko et al., 2008), and
have significantly higher social phobia severity ratings compared to non-ASD youth
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(Gadow, DeVincent, Pomeroy, & Azizian, 2005). Recent research suggests that adults with
PDD desire social interactions; however, they experience increases in negative affect and
anxiety in the presence of less familiar people, akin to the experience of individuals with
social anxiety (Hintzen, Delespaul, van Os, & Myin-Germeys, 2010). It is possible that
anxiety compounds the overall social impairment associated with ASD, and the social
difficulties associated with ASD produce anxiety (White et al., 2009). This may be
particularly true among higher functioning children or children with autism spectrum
deficits who lack a formal diagnosis, as these youth are more likely to have awareness of
their social deficits.
Concerns have been raised regarding the ability of current diagnostic systems to accurately
characterize anxiety in ASD youth. Confusion regarding substantial symptom overlap
between ASD and anxiety disorders as well as a lack of clearly defined criteria for
differential diagnosis has contributed to inconsistencies in the reported prevalence of many
anxiety disorders in this population (Puleo & Kendall, 2012; White et al., 2009). Core
symptoms of ASD may be misidentified as co-occurring anxiety, particularly for social
phobia (Wood & Gadow, 2010). Conclusions regarding differential rates of anxiety
diagnoses among ASD youth remain unclear. For example, some studies suggest that
children with ASD experience generalized anxiety disorder (GAD) at rates higher than that
found in the general population, with 9.4% to 22.7% of the samples examined meeting
diagnostic criteria (Gadow et al., 2005; Kim, Szatmari, Bryson, Streiner, & Wilson, 2000;
Muris et al., 1998; Simonoff et al., 2008; Sukhodolsky et al., 2008). However, Leyfer and
colleagues (2006) found only a 2.4% rate of GAD in their sample of ASD children. The
classification of anxiety among children with ASD may also be complicated by the difficulty
these youth have reporting their anxiety symptoms, as they may lack insight into their
internal feelings and anxious thoughts even though they can describe overt signs of anxiety
when asked (White et al., 2009).
Although there is evidence to suggest that anxiety manifests differently in children with
ASD, some research suggests the contrary; that is, youth with ASD seem to experience
similar anxiety symptoms as typically developing youth, with presentation of symptoms
affected primarily by age and cognitive functioning (Mayes, Calhoun, Murray, Ahuja, &
Smith, 2011; Weisbrot et al., 2005). White and colleagues (2009) noted that although the
developmental progression of anxiety symptoms in ASD youth may closely resemble that of
non-ASD youth, the presentation of these symptoms nonetheless differs in other respects,
such as association with sensory sensitivities and lack of emotional insight. The lack of
agreement across studies underscores the need for further research. An empirically based
understanding of the overlapping anxiety and ASD spectrums is needed to inform
assessment, case conceptualization and effective treatment planning (White et al., 2009),
particularly among children identified with principal anxiety disorders, for whom research
remains comparatively scarce.
1.2. The Present Study
The present study explored the characteristics and symptomatology of anxious youth with
ASD traits. In particular, the clinical diagnoses, severity of symptoms of depression, and
coping ability of youth with and without elevated levels of ASD symptoms were compared.
Depressive symptomatology and coping ability were examined given that previous research
has explored elevated ASD symptoms in youth with broad mood disorders (Pine et al., 2008;
Towbin et al., 2005), and these constructs are often explored in studies of youth with anxiety
disorders (e.g., Beidel et al., 2007; Hirshfeld-Becker et al., 2010; Kendall et al., 1997;
Kendall, Hudson, Gosch, Flannery-Schroeder, & Suveg, 2008; Walkup et al., 2008) as
common, co-occurring characteristics of anxious youth with implications for anxiety
presentation and treatment (Crawley, Beidas, Benjamin, Martin, & Kendall, 2008; Kendall,
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1992; Southam-Gerow, Kendall, & Weersing, 2001). It was hypothesized that patterns of
anxiety reported in previous research with ASD youth would be reflected in youth with
moderate, but subthreshold symptoms of the disorder in the current study. Specifically,
anxious youth with elevated ASD symptoms were expected to present with more social and
specific phobias, and a greater number of diagnoses overall. In addition, at the symptom
level and as an exploratory aim, we examined symptoms that best distinguish between
children with and without ASD traits.
2. Method
2.1. Participants
Participants were 100 youth (aged 7–16) who presented for treatment at an anxiety disorders
outpatient clinic (n = 33) or who participated in a randomized clinical trial (RCT) evaluating
cognitive-behavioral therapy (n = 67; Kendall et al., 2008). Parents of youth who
participated in the RCT were recontacted to complete an additional measure for the purposes
of the current study and all reachable families agreed to participate. Participant children had
met criteria for a principal diagnosis of GAD (n = 46), social phobia (n = 30), separation
anxiety disorder (SAD; n = 23), or specific phobia (n =1). Comorbidity was common: 27%
of children were comorbid with GAD, 32% with SAD, 39% with social phobia, 36% with
specific phobia, 23% with attention-deficit/hyperactivity disorder (ADHD), 8% with
oppositional defiant disorder, 8% with dysthymia, and 5% with major depressive disorder.
This high degree of comorbidity is consistent with rates found in other samples of youth
with anxiety disorders (e.g., Kendall et al., 2010). Youth with a pre-existing ASD diagnosis
based on parent report and youth whose principal diagnosis was not an anxiety disorder
were not included. Fifty-five percent of the children were male. Regarding race, 91% were
Caucasian, 6% were African American, and 3% identified as "other" or mixed race.
Children aged 7-11 years comprised 67% of the sample, and the remaining 33% were 12-16
years old (mean age = 10.57, SD = 2.38). Family income was reported as below $20,000
(1.1%), up to $40,000 (8.4%), up to $60,000 (16.9%), up to $80,000 (26.3%), and above
$80,000 (47.4%). Fathers' and mothers' education level was reported as did not complete
high school (2% and 1%, respectively), high school graduates without college (22% and
20%), some college education (20% and 15%), completed a 4-year college (34% and 37%),
attended graduate school (21% and 25%), or "other" (1% and 2%).
2.2. Measures
Anxiety Disorders Interview Schedule for Children (ADIS-C/P; Silverman &
Albano, 1996)—The ADIS-C/P is a semi-structured interview that assesses DSM-IV
anxiety disorders in youth. Interviews are independently administered to parent and child,
and combined for a composite report using the either/or rule, such that diagnoses are
assigned if either the parent or child reports a disorder of clinical severity. Interviewers
provide clinician severity ratings (CSRs) for each diagnosis on a 0-8 scale (≥ 4 required for
a diagnosis). Studies indicate favorable psychometrics (March & Albano, 1998), including
high inter-rater reliability (Chavira, Stein, Bailey, & Stein, 2004; Lyneham, Abbott, &
Rapee, 2007), retest reliability (Silverman, Saavedra, & Pina, 2001), convergent validity
(Wood, Piacentini, Bergman, McCracken, & Barrios, 2002), and sensitivity to treatment
(e.g., Kendall et al., 2008). Interviewers for the RCT and outpatient clinic were required to
meet inter-rater reliability of 0.85 (Cohen's κ). Diagnoses and symptoms of GAD, SAD,
social phobia, and specific phobias recorded during the ADIS-C/P administration were
Social Responsiveness Scale – Parent Version (SRS-P; Constantino & Gruber,
2005)—The 65-item SRS-P is a commonly used parent-report measure of ASD symptoms
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(e.g., Pine et al., 2008; Puleo & Kendall, 2011; Reiersen et al., 2008; Towbin et al., 2005).
The SRS-P measures the social deficits characteristic of ASD that are relatively independent
of other psychopathology and IQ (Constantino et al., 2003) and has been studied among
youth with principal anxiety disorders (Pine et al., 2008). Parents rate their child from "0"
(never true) to "3" (almost always true), on observed aspects of routine reciprocal social
behavior and autistic preoccupations. Scores on this measure range from 0 to 195 with
higher scores indicating greater social impairment. Of importance for this study, scores in
the moderate range (standardized scores from 60 to 75) are stated as reflective of clinically
significant deficits in reciprocal social behavior and characterize youth with mild or high
functioning autism spectrum conditions or symptoms that might complicate other, more
salient psychiatric difficulties. More severe scores are associated with more pronounced
ASDs and substantial social interference (Constantino & Gruber, 2005). The SRS has high
retest reliability (r = .83; Constantino et al., 2003), inter-rater reliability (between parents, r
= .91; Constantino et al., 2003), and internal consistency (Cronbach's alpha = .97;
Constantino & Gruber, 2005). Internal consistency in this sample was excellent (Cronbach's
alpha = .92). The SRS has shown convergent validity with the Autism Diagnostic Interview-
Revised (ADI-R; r = .7; Lord, Rutter, & Couteur, 1994; Constantino et al., 2003).
Multidimensional Anxiety Scale for Children (MASC; March, Parker, Sullivan,
Stallings, & Conners, 1997)—The MASC is a 39-item parent- and child-report that
assesses children's anxiety symptoms. The scale assesses four factors: physical symptoms,
social anxiety, harm avoidance, and separation anxiety, and yields an overall anxiety score.
The scale asks children to report how they have been thinking, feeling, or acting over the
last 2 weeks on a scale of 1 (never) to 4 (often). The MASC demonstrates solid
psychometric properties, including internal consistency (α = .86), convergent validity
(March & Albano, 1998; March et al., 1997; Wood et al., 2002), diagnostic discrimination
(Villabø, Gere, Torgersen, March, & Kendall, 2012), test-retest reliability (March, Sullivan,
& Parker, 1999), and treatment sensitivity (Walkup et al., 2008). Internal consistency of the
MASC was found to be excellent in this sample (Cronbach's alpha = .91).
Coping Questionnaire – Child and Parent (CQ-C/P; Kendall & Marrs-Garcia,
1999)—The CQ-C/P assesses child- and parent-perceptions of a child's ability to cope with
anxious distress in three challenging situations. The child and parent independently rate the
child's ability to cope with situationally-based and individualized areas of difficulty (coping
scenarios), which the child identifies as feared situations at the conclusion of the diagnostic
interview (rated on a scale from 1, "not at all able to help" to 7, "totally able to help
myself"). The three items are summed for a total score. Analyses indicate adequate internal
consistency, strong retest reliability, moderate interrater agreement, and sensitivity to
treatment (Kendall et al., 2008).
Children's Depression Inventory (CDI; Kovacs, 1985; 1992)—The 27-item CDI
measures self-reported cognitive, affective, and behavioral symptoms of depression. Internal
consistency, moderate retest reliability, and convergent validity have been demonstrated
(Ivarsson, Svalander, & Litlere, 2006; Kovacs, 1992; Masip, Amador-Campos, Gómez-
Benito, & del Barrio Gándara, 2010). In this sample, the internal consistency of the CDI
was .88 (Cronbach's alpha).
Children's Global Assessment Scale (CGAS; Shaffer et al., 1983)—The CGAS is
a clinician rating of children's global functioning across settings. Ratings take into account
the child's functioning at home and school, and the nature and quality of the child's peer
relationships. Scores range from 0 to 100, with lower scores reflecting greater impairment.
The CGAS has adequate inter-rater reliability (Dyrborg et al., 2000; Shaffer et al., 1983),
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retest reliability (Bird, Canino, Rubio-Stipec, & Ribera, 1987), sensitivity to change over
time (e.g., Findling et al., 2003), and discriminant validity (Steinhausen & Metzke, 2001).
Inter-rater reliability for the CGAS among diagnosticians in the clinic was found to be
acceptable (intraclass correlation = .73).
2.3. Statistical Analyses
Consistent with the characterizations associated with the SRS-P, children with a T-score ≥
60 on the SRS-P were considered to have elevated levels of ASD symptoms. The clinical
characteristics of youth with and without elevated ASD symptoms were examined using
ANOVA, t-test, and chi-square analyses. To explore how symptoms of anxiety differ among
youth with and without ASD traits, data were analyzed using recursive partitioning (RP), a
type of exploratory decision tree analysis (Zhang & Singer, 1999) developed for disease
diagnosis and treatment (Breiman, Freidman, Olshen, & Stone, 1984; Zhang & Singer,
1999). RP is an appropriate statistical analysis to determine which anxiety symptoms
assessed by the ADIS distinguish between youth with and without elevated levels of ASD
symptoms. RP is a nonparametric data mining procedure that builds a "tree" that identifies
exhaustive orthogonal subgroups of a population, called "nodes", whose members share
common characteristics that influence the dependent variable (Lemon, Roy, Clark,
Friedmann, & Rakowski, 2003). The data are then split into smaller and smaller nodes using
a recursive procedure until each group is perfectly homogenous. This recursive splitting
takes place separately for each "branch" of the tree. RP allows for analysis of highly
dimensional and highly correlated data in small samples (Breiman et al., 1984; Strobl,
Malley, & Tutz, 2009) and addresses the problem of analyzing highly dimensional data by
reducing it to a series of one-dimensional problems to identify a parsimonious set of
predictor variables that is sufficient to predict the outcome (i.e., differentiating between
those with and without elevated ASD symptoms).
The resulting RP tree is both a reflection of the properties of the underlying population and
the random features of the specific sample from which it was derived. Because of this, the
final model is often overfit to the specific sample and not necessarily representative of the
underlying population. The goal, however, is to specify a model that will be applicable to
any random sample from the population. The second stage of the RP procedure consists of
using cross validation to prune the full tree to an "appropriate size" to reach this goal. When
a new dataset is not available to conduct confirmatory testing on the tree, resampling the
original sample, or bootstrapping, is used to create samples to conduct confirmatory tests of
the tree. The bootstrap cross-validation procedure estimates the cross-validated prediction
error, and related standard error, for different numbers of splits. Breiman et al. (1984)
suggested using a ±1 standard error rule to choose appropriate tree size. In other words, a
good-fitting tree is one with the least number of splits and the smallest cross-validation
error, given that the tree's cross-validation error plus its standard error is less than 1 (per
definition, the relative error of a model with no splits).
The cross-validation error rate and associated variability (standard error of the cross-
validation rate) are comparable to the estimate of explained variance (1 - R2) and a
confidence interval around it in an ANOVA framework (Hellemann, Conner, Anglin, &
Longshore, 2009). In other words, saying that a tree that has a cross-validation error rate =
0.70 with a standard error = .05 is similar to saying that in 95% of samples, 25% to 35% of
the variance is explained by the tree. The relative error of the sample used to estimate the
initial tree, or the relative error, is interpreted as 1 - relative error = variance explained in the
original sample. In other words, a relative error = .65 indicates that the tree explains 35% of
the variance in the original sample.
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In this study, the size of the terminal nodes was set at 5 to avoid comparisons among groups
that are too small to be clinically meaningful. The cross validation was based on 100
bootstrapped samples. The rpart package version 3.1-46 (Therneau & Atkinson, 2010), as
implemented in version 2.11.1 of the R software package, was used to estimate the RP trees.
3. Results
3.1. Characteristics of Youth with Elevated ASD Symptoms
Youth with meaningful ASD symptoms (T-scores ≥ 60 on the SRS-P) comprised 42% of the
sample. No significant differences were found between youth with or without elevated ASD
symptoms with respect to their age, sex, race, parental education or SES. In terms of
diagnostics, youth with elevated ASD symptoms had significantly more diagnoses relative
to youth without elevated ASD symptoms, t(98) = -2.08, p = .04, though no differences were
evident in their principal diagnoses (Table 1). Youth with elevated ASD symptoms were
significantly more likely to meet diagnostic criteria for social phobia than youth without
ASD symptoms, χ2 (1, N = 100) = 4.84, p = .03, and had significantly more specific phobias
than youth without elevated ASD symptoms, t(98) = -2.09, p = .04, though both groups were
equally likely to meet criteria for at least one specific phobia diagnosis. That is, though
youth with elevated ASD symptoms had a significantly greater number of specific phobias
than youth without elevated ASD symptoms, the likelihood that an individual from either
group would meet criteria for one specific phobia was not significantly different. Youth with
ASD symptoms were not more likely to have multiple anxiety disorders or to be diagnosed
with GAD, SAD, panic disorder, obsessive-compulsive disorder (OCD), ADHD, a specific
phobia, an externalizing disorder (either oppositional defiant disorder or conduct disorder),
or a unipolar mood disorder (either dysthymia or major depressive disorder) relative to
youth without elevated ASD symptoms.
Regarding the severity of internalizing pathology, youth with elevated ASD symptoms were
not rated as having more severe principal anxiety diagnoses than youth without elevated
ASD symptoms.1 Similarly, CGAS scores based on information gathered from the parent
and child diagnostic interviews were also not significantly different between groups. No
significant differences were evident in mean total scores or on mean subscale scores of the
MASC, including: physical symptoms, harm avoidance, social fear and separation anxiety.
Depressive symptomatology (total scores on the CDI) as reported by youth was also
undifferentiated by ASD symptom status.
Analyses of differences in coping skills and scenarios revealed that youth with elevated
ASD symptoms were significantly more likely to list social/evaluation concerns (as opposed
to academic/performance concerns, separations concerns, specific fears, or fears of physical
danger) among their top three fears on the CQ-C/P than youth without such deficits,
controlling for a diagnosis of social phobia, χ2 (2, N = 100) = 7.18, p = .01; Nagelkerke R2
= .31. No significant differences were evident in the likelihood of listing a specific phobia-
related scenario (e.g., fear of doctor, dogs, heights) among the top three fears or in the total
number of specific phobia-related situations listed by youth with and without elevated ASD
symptoms on the CQ-C/P. There were also no significant differences in mean coping scores
as rated by parents or children in the high and low ASD symptom groups.
1To further examine the relationship between SRS scores and anxiety severity, we conducted linear regression analyses using
continuous SRS scores as the predictor. SRS scores were not significantly related to severity of the child's principal anxiety disorder,
F(1, 98) = .009, p >.05, nor MASC total scores, F(1, 96) = .075, p >.05, consistent with initial findings that ASD status (using a cut
off score of ≥ 60 on the SRS) was unrelated to anxiety severity.
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3.2. Symptoms of Anxiety Associated with Elevated ASD Symptoms
RP results are depicted in Figure 1. All symptoms (i.e., presence of a symptom, severity
ratings, and avoidance) from the SAD, social phobia, GAD, and specific phobia modules of
the ADIS-C/P, as well as the presence of any diagnosis were entered into the model, for a
total of 398 potential predictors. It is important to note that in RP analyses, variables are
solely identified as salient rather than as significant predictors of outcome. As such, the
variables that are identified are those whose values an individual would need to know to
potentially best predict outcome. Thus, it is more important to evaluate model fit rather than
the number of variables identified given that the results do not suggest that the predictors
identified are the only "significant" predictors of outcome as is generally conceptualized
within a regression framework.
The results revealed that the final tree explained 36% of the variance in the original sample
(relative error = 0.64) and between 18% and 40% of the variance in random samples drawn
from the population (cross validation error = 0.71, standard error = 0.11), indicating that the
overall fit of the model was good. The proportion of variance explained by the model
increases with every parameter that is added to the model (Strobl, Malley & Tutz, 2009);
thus the final tree, which was based on two predictors, explained a meaningful portion of the
variance. The best predictor of elevated ASD symptoms was severity of interpersonal worry
from the GAD section (score > 4) of the parent ADIS. Individuals with an interpersonal
worry severity score less than 5 were less likely to have elevated ASD symptoms, unless
they had a score greater than 4 on the severity of specific phobia of the doctor/dentist
(medical visits) based on the child ADIS. Severity of fear of medical visits was the best
predictor of elevated ASD symptoms only in individuals with an interpersonal worry
severity score less than 5. Having a score of less than 5 on severity of interpersonal worry
from the GAD section of the parent ADIS and a score of less than 5 on severity of specific
phobia of the doctor/dentist from the child ADIS was the best predictor of not having
elevated ASD symptoms.
4. Discussion
Forty-two percent of youth presenting for treatment of principal anxiety disorders
demonstrated clinically relevant levels of ASD symptoms according to parent report. The
diagnoses and presentations of youth with ASD symptoms largely resembled those of youth
without elevated ASD symptoms, with the following exceptions. Youth with elevated ASD
symptoms had more diagnoses and were more likely to meet diagnostic criteria for social
phobia, though social phobia was not more likely to be their principal diagnosis.
Furthermore, even after controlling for a social phobia diagnosis, youth with elevated ASD
symptoms were more likely to list social concerns among their top fears than youth without
such symptoms. These findings are consistent with the elevated rates of social worry
reported by ASD youth and their parents, particularly when cognitive impairments are
minimal (e.g., Bellini, 2004; Kuusikko et al., 2008).
Consistent with previous research indicating that ASD youth have a higher rate of specific
phobias than youth in the general community (e.g., Gadow et al., 2005; Mattila et al., 2010;
Sukhodolsky et al., 2008), youth with elevated ASD symptoms were found to have
significantly more specific phobias than those without elevated ASD symptoms. These
distinctions are informative, but the dearth of diagnostic differences between groups
suggests that children with elevated ASD symptoms are not easily distinguished from
children without these deficits, an ambiguity that warrants attention given that children with
ASD traits have differential responses to particular modalities of cognitive behavioral
therapies (Puleo & Kendall, 2011).
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RP revealed that ASD symptoms were best predicted by having a GAD interpersonal worry
severity score greater than 4 on the parent ADIS, a finding that reflects that youth with
elevated ASD symptoms were best distinguished from youth without such elevations by
parent impressions of their child's interpersonal worry. For youth with a parent-reported
GAD interpersonal worry severity score less than 5, having a score greater than 4 on the
severity of fear of the doctor/dentist based on the specific phobia module of the child ADIS
was the best predictor of elevated ASD symptoms. In other words, if parents did not report
severe interpersonal worry, youth with ASD symptoms could still be distinguished by higher
child-reported fear of going to the doctor or dentist. Notably, these two symptoms
distinguished between youth with and without symptoms of ASD better than the presence of
any diagnosis obtained from the ADIS-C/P. RP identified GAD interpersonal worry and fear
of medical visits as the best from a set of 398 possible predictors, suggesting that these are
salient predictors of elevated ASD symptoms that can facilitate clinicians' ability to identify
children with elevated ASD symptoms among youth presenting for treatment of anxiety
disorders in the absence of an ASD-specific assessment.
It is important to note that GAD interpersonal worry is somewhat distinct from the social
fears characteristic of social phobia. Social phobia is primarily associated with fear of not
meeting the standards set by others; by contrast, GAD is usually associated with self-
imposed standards (i.e., having high standards for oneself). GAD worry about interpersonal
matters focuses on worries children have about the impression they make on others, their
appearance, being a good friend, and having enough friends rather than fears of rejection or
negative evaluation from others in the presence or anticipated presence of others (Albano &
Silverman, 1996). The GAD interpersonal worry item therefore assesses the extent to which
children worry about not being good enough interpersonally rather than fear of and distress
related to being in certain social situations.
The question of whether youth with ASD are aware of and distressed by worries of an
interpersonal nature remains unclear. Youth with ASD symptoms presenting to a primary
anxiety disorders clinic tend to be high functioning and lack severe cognitive impairments;
thus, they may have better awareness of their social skills deficits relative to the broader
ASD population. Alternatively, it may be that parents believe their children are worrying
about interpersonal matters because this is likely to be an area of weakness when in fact
these youth are not concerned about the implications of their social skills deficits. Such an
explanation would be consistent with theories that autism spectrum deficits are related to a
reduced desire for and competence in social interaction. As noted by Wood and Gadow
(2010) and Puleo and Kendall (2012), instruments for the assessment of anxiety disorders
may misattribute ASD-related impairment to anxiety. Impairments in areas such as peer
relationships may be attributed to anxiety based on current anxiety instruments, yet the
central problem may be ASD-related social deficits. This view is consistent with the finding
that ASD children are less likely to meet criteria for social phobia if assessment items focus
on interpersonal concerns rather than avoidance (Leyfer et al., 2006).
However, other research suggests that youth with ASD, particularly high-functioning
children who have awareness of how they are different from their peers, are concerned about
such interpersonal matters (e.g., Farrugia & Hudson, 2006; Sukhodolsky et al., 2008). There
is evidence that individuals with ASD desire social relationships, yet lack friendships due to
feelings of anxiety and depression that occur in the presence of less familiar people (Hintzen
et al., 2010). Parent-reported severity of interpersonal worry may therefore reflect the
presence of this type of worry among high functioning children with elevated ASD
symptoms. The current findings are consistent with previous research suggesting parent
report of their child's social worries is higher than child self-report among ASD youth,
perhaps signifying that parent reports are more accurate in this domain because these youth
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lack understanding about the connection between social deficits and anxiety (Russell &
Sofronoff, 2005). Taken together with the finding that youth with elevated ASD symptoms
in this sample were more likely to identify social concerns as one of their top fears, it seems
likely that these children were experiencing high levels of worry regarding interpersonal
matters. It is important to note that regardless of whether parent-report of severity of
interpersonal worry reflects true anxiety in this domain as experienced by youth with ASD
symptoms, severity on this assessment item can help clinicians identify youth with elevated
ASD traits who present to an anxiety outpatient clinic.
Results are also consistent with previous research suggesting youth with ASD have a greater
fear of physical injury and medical situations relative to youth without ASD (e.g., Russell &
Sofronoff, 2005). In particular, previous studies suggest that the specific phobias apparent
among youth with ASD are more likely to involve situations in which sensory stimulation is
salient (e.g., receiving needles and/or shots, being in crowds, loud noises; Leyfer et al.,
2006). Given that youth with ASD often show heightened sensitivity to environmental
stimulation and difficulties in sensory modulation that are related to anxiety (Pfeiffer et al.,
2005), these youth may be more likely to show fears of situations involving intense,
unwanted sensory stimulation. It is possible that fear of doctor/dentist visits distinguished
youth with ASD symptoms in this sample better than fear related to other specific phobias
involving sensory stimulation due to the specific sound and touch sensitivities elicited by
these visits. Whereas both youth with and without ASD symptoms are commonly distressed
by getting a shot or having their blood drawn, youth with ASD symptoms may report
relatively more intense fear of going to the dentist or doctor as a result of the unwanted
sound and touch stimulation that occurs during these visits (e.g., sound of dental equipment
or touch during physical examination) that does not distress youth without ASD symptoms
to the same degree. Whether these symptoms warrant a separate diagnosis of specific phobia
or are better conceptualized as an ASD-related sensory deficit remains open to question.
Potential study limitations should be noted. Participants did not meet diagnostic criteria for
ASD; thus, generalization of these findings to children with more impairing ASD deficits is
unclear. Assessment of ASD symptoms was based on parent-report, and multiple method
assessment of ASD symptoms would strengthen the conclusions. Participants were mostly
Caucasian and middle to upper class; thus, other samples are needed to determine the
generalizability to children of other racial and economic backgrounds. The recursive
partitioning analyses were exploratory and confirmatory analyses in other samples are
needed. Finally, further research on the SRS is needed among youth with anxiety disorders
to determine if SRS scores capture symptoms of anxiety that may overlap with ASD.
The current study has several notable clinical implications. The findings confirm that a large
percentage of youth presenting for treatment at an anxiety clinic have clinically meaningful
symptoms of ASD. The lack of diagnostic differences among these youth suggests that
children with elevated ASD symptoms are not easily distinguished from children without
such deficits on the basis of anxiety diagnoses alone. However, youth with ASD symptoms
can be identified by differences in anxiety symptoms. Children with elevated ASD deficits
are less likely to benefit from individual compared to family-based cognitive-behavioral
treatments for anxiety disorders relative to children without moderately elevated ASD
deficits (Puleo & Kendall, 2011). This differential treatment response underscores the need
for early identification of such youth to allow for a more tailored treatment. The present
findings suggest an efficient path to help identify and treat youth otherwise at risk for
suboptimal treatment outcomes based on differences in anxiety presentation. Specifically,
the results suggest that youth with ASD symptoms experience more severe interpersonal
worry and fear of medical visits, which are both important treatment targets. Such
differences in anxiety symptoms will likely influence the focus of their treatment. The
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clinical implications of these findings warrant replication and compel further research
regarding the presentation of co-occurring anxiety and autism spectrum symptoms in
children as well as the development of personalized anxiety interventions for these youth.
This research was supported in part by National Institute of Mental Health Grants (MH59087; MH063747;
MH086438) awarded to Philip C. Kendall. We would like to thank Craig C. Matz and Alyssa M. Forgione for their
help with this project. Abstract
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Puleo CM, Kendall PC. Anxiety disorders in typically developing youth: Autism spectrum symptoms
as a predictor of cognitive-behavioral treatment. Journal of Autism and Developmental Disorders.
2011; 41:275–286.10.1007/s10803-010-1047-2 [PubMed: 20694508]
Settipani et al.Page 15
J Anxiety Disord. Author manuscript; available in PMC 2013 April 1.
NIH-PA Author Manuscript
NIH-PA Author Manuscript
NIH-PA Author Manuscript


text:
QandA May 25th - response to question on Ryan Commission Report
By KINGKANE152 - YOUTUBE
Updated: Sat, 18 Sep 2010 13:22:53 UTC
This video was posted last year should be viewed by anyone who hasn't seen it and is hard not to watch again if you have seen it before. Actually I should say hard to watch in either case. Incredibly moving.
Thanks to Jason for the link
The rebranding of circumcision as...
Brendan O'Neill - The Telegraph Comments
The rebranding of circumcision as 'child abuse' echoes the ugly anti-Semitism of medieval Europe
German court rules religious...
- - MedicalXpress Comments
German court rules religious circumcision on boys an assault
Jehovah's Witnesses Told to Pay in...
AP - New York Times Comments
Jehovah's Witness organization found responsible for paying 40% of damages awarded to abuse victim
Ultra-Orthodox Shun Their Own for...
Sharon Otterman & Ray Rivera - The... 46 Comments
Ultra-Orthodox Shun Their Own for Reporting Child Sexual Abuse
Protest against the "Punch your gay...
Justin Griffith - Freethought Blogs -... 67 Comments
Police say 500 expected at our Protest of the pastor who said to 'punch your gay kids' [time sensitive]
Q&A for Sean Faircloth "Can Religion...
- - RichardDawkins.net 2 Comments
Q&A for Sean Faircloth "Can Religion Justify Bullying Children"

subset: commoncrawl


text:
CHRISTCHURCH Posts
"I love brains — not in a zombie sort of way — I love discovering how they work."
Occupational therapist Julie Frew explores a thought: science can be interpreted as very bleak, but also full of hope. In "Universal Grey Matter" from PKN Christchurch Vol. 21 she draws parallels between the human brain and our vast universe.
"'Just imagine,' 'I wonder,' and 'What if' are some of my favorite words in the English language. They conjure up the possible, the impossible, and the just plain crazy."
Abigail Walsh tells us a story of sheep, and his best friend bird. In "The Story of Sheep" from PKN Christchurch Vol. 21 we also hear about elephant, a retired mountain guide who sheep desires to meet. Abigail tells us how her story came to life, and how it was interwoven with her own.
"When I see that little locomotive, I smell the engine oil, it takes me back — I'm a kid again."
TV screenwriter Andrew Gunn reveals to us his dirty little secret -- his love for model trains!
In "Loco-motives" from PKN Christchurch Vol. 20, Gunn expresses his love for model trains, and how they allow him to escape into a fantasy world. He compares his job as a script writer for children's films to these miniature train worlds and says that he enjoys the feeling of safety and wonder these worlds provide.
"At the moment our culture doesn't really allow us to talk about sex."
Katie Cowan wants us to talk more about sex. And in "I Want to Talk about Sex" from PKN Christchurch Vol. 20, she goes into depth on reasons how sex can be a great thing, and how open and frank discussions about sex can only help bridge the void between men, women, and their partners.
"The church was empty, no one was sitting there, not even me. Nothing. It was the most beautiful thing I had ever felt."
Cartoonist and illustrator Dylan Horrocks begins with his childhood desire to believe in fantastical beings. In "The Empty Church: My Year of Belief" from PKN Christchurch Vol. 20, he shows us how after years of Atheism, he decided to give belief a chance, and he surveyed people in an attempt to see things through their eyes. He soon found the border between religion and unbelief was much more complicated that he had thought.
Transforming post-earthquake Christchurch vacant lots into art spaces:
Urban Strategist Brie Sherow brokers vacant spaces for creative projects in quake torn Christchurch. In a city full of empty lots, Brie and the team at Life in Vacant Spaces help facilitate the short term leases of empty space to temporarily rejuevite sites.
In "The Evolution of a Vacant Site" from PKN Christchurch Vol. 19, Brie explains how one site over the course of 7 months hosted a wide variety of artistic and community projects.
Christchurch is coming up on its momentous 20th PechaKucha Night -- a volume number we definitely love seeing a city reach -- and here's the poster to prove it. For more details about the event, please visit the official event page.
The Miserable Hour: the Time After the Time When All is Good
"This is a story about a sad meerkat with a drinking problem..."
Improvisational comedian Derek Flores, accompanied by Katie Cowan on the piano, tells the fictional story of Jarvis the meerkat, who becomes enlightened one day, learning how to create his own joy through the power of the library. In "The Miserable Hour: the Time After the Time When All is Good" from PKN Christchurch Vol. 19 Derek is ambushed with twenty images set to music, and asked to spin metaphorical thread into comedy gold.
Cycling isn't back in style -- it never left.
Richard Hayman describes his two passions: cycling and architecture. They may seem like two different ideas, but they have more similarities between them then people may think. In "Cycling is the New Black" from PKN Christchurch Vol. 18, Richard talks in more detail about the relationship between cycles and architecture and how both are a series of different parts that join together to make a beautiful whole.
Do you know where the ingredients in your food come from?
Local chef Alex Davies uses produce foraged and sourced from only the Canterbury region. Since working with seasonal foods, his menu changes daily depending on what he has each day. In "A Local Food Project" from PKN Christchurch Vol. 18, we see that Alex develops relationships with his growers and can always tell you the story of where your food came from that day. He now operates an open kitchen at a local cafe and wine bar called Shop Eight.


text:
Split Luxury hotels
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text:
Exer securizes mobile apps with Pradeo Security Solutions
France: French mobile security solution editor Pradeo Security Solutions has appointed network and security VAD Exer as its official distributor in the country for its indirect strategy. In the past, Pradeo was working with Hermitage, a distribution contract which has been ended some time ago.
Vade Retro, Exer
France: network and security VAD Exer has inked a distribution deal with local antispam editor and service provider Vade Retro. It becomes the second Vade Retro distributor in the country, beside incumbent Cris Réseaux.
MobileIron appoints Exer
France: Enterprise Mobile Management editor MobileIron has expanded its distributor stable with network and security VAD Exer.
Stormshield drops four distributors
France: the reorganization of the distribution network of Stormshield (formerly known as Netasq+Arkoon), down to two VADs (CRIS Réseaux and Exer), has made three victims : VADs Abbakan, ACTN, Arrow ECS and D2B.
A new head for Additional Design
France: following the retirement of its founder Lucien Dalmasso, Exer Group has promoted Xavier Saillard to new director and business development manager of its storage arm, Additional Design.
Se requiere su registro
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Stefanie Pish
Stefanie Pish
Fisherman's Village Realty
Punta Gorda, FL 33950
1200 West Retta Esplanade
Stefanie's experience in real estate covers buyers, sellers, renters, and all aspects of property management. Stefanie has worked with many buyers, sellers, and investors to find their perfect property. Thinking of buying but not sure you can afford it? Thinking of selling but wondering what your property can rent for? Wondering what your home could sell for in today's market? Stefanie can help you answer all of these questions and more!
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text:
- Episode Description
Caleb, Remy, and Olivia decide to conduct a séance to show Luke that the town, Ravenswood, isn't being haunted like he thinks. While all that is going on, Olivia gets more information on her father's mysterious death. Remy begins to worry about her mom's condition lately since her mom came back from Afghanistan. Miranda turns to Caleb for help about the feeling she is being observed by someone.
- Cast & Crew
Nicole Gale Anderson
Tyler Blackburn
Steven Cabral
Brett Dier
Britne Oldford
- Fan Reviews (0)
- Be the first to write a review!
WynnekToma Nov 16, 2013
I also thought that Abbey looks a lot like Alison from PLL. I am also realy loving this show because unlike most other T.V. show series this one gets under my skin and realy makes me jump. I know for sure that Mr. Collins and Ms. Grumwald has something to do with or knows something about the curse; perhaps they both or only Mr. Collins survived the curse or because one or both of them are not dead they might be the reason for the curse in Ravenswood.
sasou82 Nov 13, 2013
I thought that this episode was pretty good. But, I thought that the girl at the grave site looked like Alison, not like the mayor's high school girlfriend. I am loving Caleb on this show especially since I never thought they used him enough on PLL. Do I think this show is as good as PLL? No... but I don't doubt that it will get better as long as ABC Family does not cancel it as it has with other shows that have been promising (Bunheads, Huge, The Nine Lives of Chloe King).
KasenStuff Nov 13, 2013
Okay this show is definitely creepy and the story is much better than Pretty Little Liars, I just don't get Caleb being here instead of Rosewood. Just doesn't make sense. And some of the acting is terrible. Other than that, definitely prefer it.


text:
OP Junior Member
Thanks Meter: 0
2 posts
Join Date:Joined: Dec 2013
The phone rings when I get calls, I can answer and talk on the phone. But the LCD screen is blank. I can see the backlight is on. But nothing on the LCD.
I am not sure what is damaged. Is the LCD screen damaged or did some electronics get damaged?
I opened up the phone and tried reconnecting the screen. But no use.
I also froze the phone overnight. But again no use.


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abkmot - not found
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One word anagrams of abkmot:
Words formed by adding one letter before or after abkmot (in bold), or to abkmot in any order:
c - tomback s - tombaks
Shorter words found within abkmot:
ab abo am ambo amok at atom ba bam bat bo boa boat bot bota ka kab kat koa kob ma mako mat mo moa moat mob mot oak oat oka om ta tab tam tao to tom tomb
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ACE Fit Share
Add some diversity to your fitness program with these butt and hip exercises from the American Council on Exercise. We'll help you tone up those glutes and get that butt into shape. Choose from a wide variety of hip flexibility and strengthening exercises including glute bridges, BOSU lateral jumps and more. These exercises come with detailed instructions, step-by-step guidance and tutorials on proper equipment use. For full workout routines featuring butt and hip exercises, be sure to visit our Workouts section.
Fit Life Articles
Do your New Year's resolutions feel like a distant memory? If so, don't feel discouraged. There's no reason you can't start working toward those goals again. To give you the best possible chance at achieving your resolutions, here are three strategies that will help you...
When it comes to achieving your goals and being successful, the mind is, by far, the body's most powerful muscle. And just like the rest of the body, the mind needs to be trained to perform at its best. If you feel plagued by self-doubt, self-criticism or fear, you can...
Thinking about joining a health club or fitness studio to help meet your fitness goals? Before you sign a contract, ACE Certified pro Pete McCall urges you to ask yourself some questions to de-termine which option is best for you. Here, he presents the pros and cons of both...
ACE Pro Homepage
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WIP Bird of Paradise
Here is an update on my bird of paradise. This is the first mosaic that I've ever done. It is 3' x 5'. I finally got a chance to work on it again. Hope fully I'll get it done before winter.
Thanks for all of your comments. I still have a lot to do on it. I'll have to soon be cutting and fitting all the little tile around the flower petals. Then the grouting. This thing is going to weigh a ton. I'll probably have more questions the closer I come to the actual grouting.
It's supposed hang outside under my patio. My son is going to make me an aluminum frame to hang it from so I hope it will be strong enough to support it. However it's getting heavier and heavier, so I'm having second thoughts on whether or not it will work.


text:
President to Address DADT Repeal in State of the Union Tonight
January 25, 2011 by HRC staff
Post submitted by Michael Cole-Schwartz, Former HRC Director of Communications
Upon news that the President will announce in tonight's State of the Union that open service by gays, lesbians and bisexuals in the U.S. Armed Forces will begin this year, HRC President Joe Solmonese issued the following statement:
Very soon, what will matter in the U.S. military is how you do your job, not your sexual orientation. Last year the President committed to working with Congress to repeal the ban on open service by gay, lesbian and bisexual people and tonight's announcement is welcome news for all Americans ready to close the book on discrimination in the ranks. Not only does repeal mean troops will be treated with the dignity and respect they deserve, but our nation will be stronger with the best and brightest able to serve in uniform. Tonight is the culmination of a promise kept by this President. The issue most prevalent in tonight's speech was jobs and with discrimination in the military soon behind us, there remain a number of pressing issues for the lesbian, gay, bisexual and transgender community when it comes to economic security. The President and Congress can do much more to ensure the economic empowerment of LGBT people including ending the unfair taxation of partner health benefits, prohibiting workplace discrimination on the basis of sexual orientation and gender identity, and ensuring that all married couples have access to the same federal benefits and protections for their families. We look forward to working with this President and allies in Congress on the challenges ahead.
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February 18, 2015
HRC's Time to Thrive Conference Kicks Off in Portland, Oregon
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February 16, 2015
"Love Has No Labels" Ad Campaign Celebrates Diversity and Inclusion
February 18, 2015


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30 people evacuated from apartments after fire
Top Stories in Local
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Rackspace settles dispute over HQ project
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Gregg Popovich does not care for your half-court 3, Mario Chalmers
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Stone Oak restaurant opening mid-April
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'Downton Abbey' Stars invade Hollywood as series ends
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Things today's kids will never do
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Markets on the right side of history
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2014 Toyota Avalon — virtually the same as the 2015 model
Top Stories in Cars
Gloomy China, Japan data add to pressure for stimulus
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Inside a Dallas Cowboy's Texas mansion
Top Stories in Homes
You can't shell out for everyone, but you don't want to offend, either. Here, a list of cheapish ways to bring them over to your side.
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Begin New Search
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Louella Christensen
member for 5 years, 8 days
Add to MyFriends
Bio and Links
Isn't this a great ride we're on? Genealogy is such an interesting and rewarding hobby! I'm frequently amazed (and sometimes disturbed) as I learn more about the daily lives of my ancestors, and the hardships they faced as they immigrated to America and made their way west to Illinois and beyond. And, how DID they manage to raise such large families in the days before TV, washing machines and microwaves???
In addition to working my own family history, I'm on the Sidener Cemetery Board. I'm related to about three-fourths of the people buried in the cemetery! Sidener Cemetery is located in rural St Elmo, Fayette County, Illinois. Since being elected to the Board, I've mapped the cemetery for them, completed a cemetery survey book, finished photographing grave stones, and entered the remaining Sidener graves on FindaGrave. It's been a busy time! We're still looking for photos of people buried in Sidener Cemetery to post on their FindaGrave memorials and for information to help us add family links.
Feel free to use the information and cemetery photos I've added here in your family trees on other genealogy websites such as Ancestry.com or in your own family history records. There's no need to contact me directly for permission. Just indicate who provided the photo and that it is being used with permission.
I'm always happy to transfer memorials of any non-relatives that I've entered to their family members upon request. As they say, "Many hands make light the work." It's great to be a member of the Find A Grave community!
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Rickey Boult
Thank you and you may use anything of mine for your family tree use, If I can ever help you in anyway, please let me know.
A friend for life,
Added by
Rickey Boult
on Feb 21, 2015 4:56 PM
Lannie Bartlett
Charlie Knutson
Hi Louella! I have Charles' parents (and the rest of the family) here in Find A Grave.
Dad - Webjorn #58448245
Mom - Hanna #90906816
Lannie (Knutson) Bartlett (Great-granddaughter of Charlie's brother Peter).
Added by
Lannie Bartlett
on Jan 20, 2015 7:24 PM
2Lt Arthur Kazarian
Good morning, some months ago I and other people discovered the exact place were Lt. Arthur Kazarian died in Italy june 15 1944. We are looking for people related looking for photos or something else. We are trying to celebrate with a plaque the next anniversary.
Can you someway help us ?
thanks a lot in advance
Mauro Bifani
Added by
on Dec 19, 2014 8:44 AM
fontina gilbert
RE: Looking for my dads sister
Hello again. Sorry it has taken me so long to get back to you. My dad has passed away. His date was 9/30/1993. He was a retired Senior Chief Petty Officer in the Navy and served 33 years.
There is also another brother not listed, Lenard Hendrickson who has passed and lived in Vallejo, California. He was older than my dad. I will find out the dates for you.
I thank you for your information and will contact the court house soon. The brother Harold was one my family never heard of. He passed away at birth but was buried in a different cemetery, Guy Cemetery. Was it common to bury children in different cemeteries? Since my grandmother was a Sidener I would have thought all her young children would be buried in the family cemetery. That is why I thought Bonnie would have been found there. I am looking for all siblings of my dad and should I find more infant deaths I will certainly send you the information. Is it possible to place a military memorial honoring my dad by his parents grave? I know the military will furnish one and he at one time wanted to buried by his mom. We had him placed here in Pensacola so we could be close.
Thank you for your time and hard work.
Added by
fontina gilbert
on Nov 25, 2014 8:54 PM
Sandra Kay "Collins" Prochnow
Cemetery in Italy
Thank you for getting the picture of the Entrance to the cemetery were my husbands uncle is buried.
Sandra Prochnow
Added by
Sandra Kay "Collins" Proc...
on Nov 17, 2014 12:02 PM
Betty Myers
Johnny Ralph Kimberlin
He was the son of Grover Ralph and Monda Leona Wilber Kimberlin. Johnny Ralph was the 6th of 17 children born to them. His grandparents are Gilbert Thomas and Margaret Leona Rine Wilber. All are buried in Griffith Cemetery. He died in Houston, Harris, Texas.
Added by
Betty Myers
on Nov 10, 2014 8:39 PM
fontina gilbert
Looking for my dads sister
My dad was born in St Elmo Illinois on 10/14/1916 and had several brothers and sisters. His parents were Della Mary Sidener and McPherson Hendrickson.
His sister passed away a few months before he was born.
Her information is
Bonnie Hendrickson (middle was spelled Wanita or maybe Juanita but photos have it as Wanita)
Died 3/23/1916.
My dad is Donald Willard Hendrickson.
His parents are buried in the Sidener cemetery.
I cannot locate her grave and she is not listed as a child to either parent on this website.
How do I find out about her cemetery and grave?
Thank you for your help.
F. Gilbert
Added by
fontina gilbert
on Nov 02, 2014 7:20 PM
Beth & Doug
Maria Knecht (Sp?)
Hello Louella,
I found Maria however it was the wrong one. You will have to re-request Maria I had the one who died in 1928. (I couldn't see the etchings very well) Sorry about that. Have a good day.
Added by
Beth & Doug
on Oct 19, 2014 5:51 PM
Lipsey Family
I am so glad to hear that you are related and very "into" genealogy. I am researching the Lipsey Family for my best friend (her family line) and I am wondering if you have any information on the death, burial, whereabouts of John Kingsley Lipsey.
My private email is firstname.lastname@example.com
I would appreciate any information you are willing to share!!
Added by
on Oct 08, 2014 12:20 PM
Kristin Baker
108481669 Henry H Storck Saint Paul IL
I have additional information about Henry Storck. The dates on the tombstone match an Illinois death record. https://familysearch.org/pal:/MM9.1.1/N3XB-Z93 Herman Henry Frederich Storck. Born in Grand Prairie, Washington Co., Ill. His parents are Frederick Storck and Dorothea Lampe. His wife is Maria Kolstar. Fred and Dorothea are my 3rd Grand Parents.
Added by
Kristin Baker
on Oct 05, 2014 3:33 PM
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A running doll has become the must-have accessory for aspiring children runners. 'Runner Girl' Ella is part of a range of sport-themed dolls developed by Jodi Norgaard, founder of Dream Big Toy Company.
26 Mar
26 Mar
A running doll has become the must-have accessory for aspiring children runners. 'Runner Girl' Ella is part of a range of sport-themed dolls developed by Jodi Norgaard, founder of Dream Big Toy Company.
25 Mar
This weekend will see the hosting of one of the UK's oldest and longest cross country races. The Orion 15 covers off road terrain in and around the Epping Forest area in north east London.
25 Mar
Elite athletes from across South of England visited Richmond's Old Deer Park to take part in the grass elite mile organised by the Salomon CityTrail Richmond Half Marathon on Sunday (22 March).
24 Mar
Lord of the Rings star, Sean Astin, is preparing to take part in this year's Boston Marathon. He will be running the Boston event as part of Team MR8 - formed in honour of eight-year-old Martin Richard who was killed in the 2013 Boston Marathon bombing.
24 Mar
Entries for London's leading corporate running challenge, the Standard Chartered Great City Race, are now open. The 5k race, which this year takes place on Thursday 9 July, will see entries from 5,000 runners from 350 companies representing the industries of banking, accountancy, insurance, law and the media.
23 Mar
21 Mar
The International Association of Athletics Foundation (IAAF) has reacted to the cases of both Liliya Shobukhova and Rita Jeptoo by implementing out-of-competition testing for performance-enhancing drugs. Such is the IAAF's determination in revising the laws, elite athletes could be subject to the testing as early as this summer.
20 Mar
Olympic medallist and Great Run Series founder Brendan Foster and Mayor of Newham, Sir Robin Wales, have unveiled their vision to create the UK's biggest mass participation running event.
19 Mar
Five members of Parliament have signed up to take part in this year's Virgin Money London Marathon. The quintet includes three front benchers, taking time off from the General Election race to run the streets of the capital on Sunday 26 April. Parliament dissolves on 30 March 2015, meaning all five will officially run as members of the public rather than MPs, before returning to the campaign trail to try to win back their seats in the General Election on 7 May.
18 Mar
Kenenisa Bekele has announced his withdrawal from next month's Virgin London Marathon due to an injury on his right achilles tendon. News of Bekele's absence, however, was countered by confirmation Geoffrey Mutai, twice winner of the New York Marathon, has been added to the elite field.


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I want to add a directory to my PATH through the ~/.bash_profile file, though I don't have a file like this in my Ubuntu. I have the following code, which will check whether people have that file or not, and if not will create one and add all the existing path directories and the one entered by the user.
echo "Please enter a directory that you want to add to your PATH: "
read dr
if [ -f ~/.bash_profile ]
# Add the read 'dr' directory to the end of the line that starts
# with PATH=, in your ~/.bash_profile file
source ~/.bash_profile
echo "PATH=$PATH:$dr" > ~/.bash_profile
echo "export PATH" >> ~/.bash_profile
source ~/.bash_profile
The point is that, if the file already exists, I don't know how can I check to find the line that starts with PATH=, and then add the directory entered by the user to the end of that line. Please note that this is just an exercise given to me. I should add a directory entered by the user to the PATH through ~/.bash_profile. Though, I don't know why someone should bother to use ~/.bash_profile to add new directory to the PATH.


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Heather slow to turn green this spring?
miltongardenMay 19, 2010
I have C.V. Yvette's Silver, C.V Alba, generic C.V. Bud Bloomer, and others I can't identify right now. As in the past they turned a bronzeish color or gray color over the winter. By mid-May they are usually all green again. This year (2010) some are turning green, but at a much slower pace. Some have not started to turn at all. Is anyone else running into this? Any suggestions?