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Mingins JE, Tarver J, Pearson E, Edwards G, Bird M, Crawford H, Oliver C, Shelley L, Waite J. Development and psychometric properties of the Clinical Anxiety Scale for People with Intellectual Disabilities (ClASP-ID). J Neurodev Disord 2024; 16:43. [PMID: 39068415 PMCID: PMC11283710 DOI: 10.1186/s11689-024-09554-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 06/25/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND There is a critical need for the development of dependable and valid anxiety assessment tools suitable for people with moderate to severe intellectual disabilities, particularly those who speak few or no words. Distinguishing anxiety from distress caused by physical discomfort (pain) or characteristics associated with autism, prevalent in this population, necessitates specialised assessment tools. This study (a) developed a parent-report anxiety questionnaire tailored for individuals with severe to moderate intellectual disabilities, potentially with a co-diagnosis of autism, and (b) evaluated the psychometric attributes of this novel measure. METHODS A comprehensive approach involving literature reviews, inspection of existing tools, and interviews with clinicians and parents guided the creation of the Clinical Anxiety Scale for People with Intellectual Disabilities. The tool was completed by parents or caregivers (N = 311) reporting on individuals aged 4 or older with intellectual disabilities. RESULTS Exploratory factor analysis indicated a four-factor structure encompassing anxiety, pain, low energy/withdrawal, and consolability. The anxiety factor explained the most variance in scores (26.3%). The anxiety, pain, low energy/withdrawal subscales demonstrated robust internal consistency (α = 0.81-0.92), and convergent, divergent, and discriminant validity. Robustness of these subscales was further evidenced by test-retest reliability (ICC = 0.79-0.88) and inter-rater reliability (ICC = 0.64-0.71). Subgroup analyses consistently demonstrated strong psychometric properties among individuals diagnosed with non-syndromic autism (N = 98), children (N = 135), adults (N = 175), and across diverse communication abilities within the sample. Moreover, individuals diagnosed with both autism and anxiety exhibited significantly higher scores on the anxiety subscale compared to those without an anxiety diagnosis, while showing no difference in autism characteristic scores. CONCLUSIONS The findings indicate that the Clinical Anxiety Scale for People with Intellectual Disabilities is a promising measure for use across diverse diagnostic groups, varying communication abilities, and with people with moderate to severe intellectual disabilities.
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Affiliation(s)
- Jessica Eliza Mingins
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, B4 7 ET, United Kingdom.
| | - Joanne Tarver
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, B4 7 ET, United Kingdom
| | - Effie Pearson
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, B4 7 ET, United Kingdom
| | - Georgina Edwards
- School of Health and Care, Coventry University, Priory St, Coventry, CV1 5FB, England
| | - Megan Bird
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, B4 7 ET, United Kingdom
| | - Hayley Crawford
- Mental Health and Wellbeing Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, England
| | - Chris Oliver
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, England
| | - Lauren Shelley
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, B4 7 ET, United Kingdom
| | - Jane Waite
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, B4 7 ET, United Kingdom
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Ferrer-Mallol E, Matthews C, Aziza R, Mendoza A, Sahota N, Komarzynski S, Lakshminarayana R, Davies EH. Video-based assessments of activities of daily living: generating real-world evidence in pediatric rare diseases. Expert Rev Pharmacoecon Outcomes Res 2024; 24:713-721. [PMID: 38789406 DOI: 10.1080/14737167.2024.2360201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 05/22/2024] [Indexed: 05/26/2024]
Abstract
INTRODUCTION Preserving function and independence to perform activities of daily living (ADL) is critical for patients and carers to manage the burden of care and improve quality of life. In children living with rare diseases, video recording ADLs offer the opportunity to collect the patients' experience in a real-life setting and accurately reflect treatment effectiveness on outcomes that matter to patients and families. AREAS COVERED We reviewed the measurement of ADL in pediatric rare diseases and the use of video to develop at-home electronic clinical outcome assessments (eCOA) by leveraging smartphone apps and artificial intelligence-based analysis. We broadly searched PubMed using Boolean combinations of the following MeSH terms 'Rare Diseases,' 'Quality of Life,' 'Activities of Daily Living,' 'Child,' 'Video Recording,' 'Outcome Assessment, Healthcare,' 'Intellectual disability,' and 'Genetic Diseases, Inborn.' Non-controlled vocabulary was used to include human pose estimation in movement analysis. EXPERT OPINION Broad uptake of video eCOA in drug development is linked to the generation of technical and clinical validation evidence to confidently assess a patient's functional abilities. Software platforms handling video data must align with quality regulations to ensure data integrity, security, and privacy. Regulatory flexibility and optimized validation processes should facilitate video eCOA to support benefit/risk drug assessment.
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Jacobs P, Power L, Davidson G, Devaney J, McCartan C, McCusker P, Jenkins R. A Scoping Review of Mental Health and Wellbeing Outcome Measures for Children and Young People: Implications for Children in Out-of-home Care. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:159-185. [PMID: 38938951 PMCID: PMC11199430 DOI: 10.1007/s40653-023-00566-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/11/2023] [Indexed: 06/29/2024]
Abstract
Purpose One of the challenges for mental health research is the lack of an agreed set of outcome measures that are used routinely and consistently between disciplines and across studies in order to build a more robust evidence base for how to better understand young people's mental health and effectively address diverse needs. Methods This study involved a scoping review of reviews on consensus of the use of mental health and wellbeing measures with children and young people. We were particularly interested to identify if there are differences in measures that are recommended for children and young people with care experience including those with developmental disabilities. Findings We identified 41 reviews, of which two had a focus on child welfare settings, three on childhood trauma and 14 focused on children and young people with developmental disabilities. Overall, our review highlights a lack of consensus and a diversity of measures within the field. We identified 60 recommended measures, of which only nine were recommended by more than one review. Conclusions Our review highlights the need for greater agreement in the use of mental health outcome measures. While our review highlights that there is value in identifying measures that can be used with any child or young person, researchers need to take into account additional considerations when working with children and young people with care experience and those with developmental disabilities, to ensure measures are accessible and sensitive to their life experiences.
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Affiliation(s)
- Paula Jacobs
- Faculty of Social Sciences, Social Work, University of Stirling, Colin Bell Building, Stirling, UK
| | - Luke Power
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, UK
| | - John Devaney
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Claire McCartan
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, UK
| | - Pearse McCusker
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Ruth Jenkins
- Academic Support Librarian, University of Edinburgh, Edinburgh, UK
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La Valle C, Shen L, Shih W, Kasari C, Lord C, Tager-Flusberg H. Real-time coded measures in natural language samples capture change over time in minimally verbal autistic children. Autism Res 2024; 17:1287-1293. [PMID: 38670930 DOI: 10.1002/aur.3142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
Prior research supports the use of natural language sampling (NLS) to assess the rate of speech utterances (URate) and the rate of conversational turns (CTRate) in minimally verbal (MV) autistic children. Bypassing time-consuming transcription, previous work demonstrated the ability to derive URate and CTRate using real-time coding methods and provided support for their strong psychometric properties. (1) Unexplored is how URate and CTRate using real-time coding methods capture change over time and (2) whether specific child factors predict changes in URate and CTRate in 50 MV autistic children (40 males; M = 75.54, SD = 16.45 (age in months)). A NLS was collected at Time 1 (T1) and Time 2 (T2) (4.5 months between T1 and T2) and coding was conducted in ELAN Linguistic Annotator software using a real-time coding approach to derive URate and CTRate. Findings from paired samples Wilcoxon tests revealed a significant increase in child URate (not examiner URate) and child and examiner CTRate from T1 to T2. Child chronological age, Mullen expressive language age equivalent scores, and URate and CTRate at T1 were predictive of URate and CTRate at T2. Findings support using NLS-derived real-time coded measures of URate and CTRate to efficiently capture change over time in MV autistic children. Identifying child factors that predict changes in URate and CTRate can help in the tailoring of goals to children's individual needs and strengths.
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Affiliation(s)
- Chelsea La Valle
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Lue Shen
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, Massachusetts, USA
| | - Wendy Shih
- Center for Autism Research & Treatment, Semel Institute, UCLA, Los Angeles, California, USA
| | - Connie Kasari
- Center for Autism Research & Treatment, Semel Institute, UCLA, Los Angeles, California, USA
| | - Catherine Lord
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, California, USA
| | - Helen Tager-Flusberg
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
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Shelley L, Jones C, Pearson E, Richards C, Crawford H, Paricos A, Greenhill C, Woodhead A, Tarver J, Waite J. Measurement tools for behaviours that challenge and behavioural function in people with intellectual disability: A systematic review and meta-analysis of internal consistency, inter-rater reliability, and test-retest reliability. Clin Psychol Rev 2024; 110:102434. [PMID: 38718632 DOI: 10.1016/j.cpr.2024.102434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 03/15/2024] [Accepted: 04/12/2024] [Indexed: 05/25/2024]
Abstract
Behaviours that challenge (BtC) are common in people with intellectual disability (ID) and associated with negative long-term outcomes. Reliable characterisation of BtC and behavioural function is integral to person-centred interventions. This systematic review and meta-analytic study quantitatively synthesised the evidence-base for the internal consistency, inter-rater reliability, and test-retest reliability of measures of BtC and behavioural function in people with ID (PROSPERO: CRD42021239042). Web of Science, Embase, PsycINFO and MEDLINE were searched from inception to March 2024. Retrieved records (n = 3691) were screened independently to identify studies assessing eligible measurement properties in people with ID. Data extracted from 83 studies, across 29 measures, were synthesised in a series of random-effects meta-analyses. Subgroup analyses assessed the influence of methodological quality and study-level characteristics on pooled estimates. COSMIN criteria were used to evaluate the measurement properties of each measure. Pooled estimates ranged across measures: internal consistency (0.41-0.97), inter-rater reliability (0.29-0.93) and test-retest reliability (0.52-0.98). The quantity and quality of evidence varied substantially across measures; evidence was frequently unavailable or limited to a single study. Based on current evidence, candidate measures with the most evidence for internal consistency and reliability are discussed; however, continued assessment of measurement properties in ID populations is a key priority.
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Affiliation(s)
- Lauren Shelley
- School of Psychology, College of Health and Life Sciences, Aston University, UK.
| | - Chris Jones
- School of Psychology, University of Birmingham, Edgbaston, UK
| | - Effie Pearson
- School of Psychology, College of Health and Life Sciences, Aston University, UK.
| | - Caroline Richards
- School of Psychology, University of Birmingham, Edgbaston, UK; Cerebra Network for Neurodevelopmental Disorders, UK.
| | - Hayley Crawford
- Mental Health and Wellbeing Unit, Warwick Medical School, University of Warwick, UK; Cerebra Network for Neurodevelopmental Disorders, UK.
| | - Arianna Paricos
- School of Psychology, College of Health and Life Sciences, Aston University, UK.
| | - Courtney Greenhill
- School of Psychology, College of Health and Life Sciences, Aston University, UK
| | - Alixandra Woodhead
- School of Psychology, College of Health and Life Sciences, Aston University, UK
| | - Joanne Tarver
- School of Psychology, College of Health and Life Sciences, Aston University, UK.
| | - Jane Waite
- School of Psychology, College of Health and Life Sciences, Aston University, UK; Cerebra Network for Neurodevelopmental Disorders, UK.
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Murphy S, Bell K, Cook EJ, Crafter S, Davidson R, Fairhurst C, Hicks K, Joffe V, Messer D, Robinson-Smith L, Strachan L, Torgerson D, Welch C. Enhancing Pragmatic Language skills for Young children with Social communication difficulties (E-PLAYS-2) trial: study protocol for a cluster-randomised controlled trial evaluating a computerised intervention to promote communicative development and collaborative skills in young children. BMC Psychol 2024; 12:266. [PMID: 38741221 DOI: 10.1186/s40359-024-01749-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND A number of children experience difficulties with social communication and this has long-term deleterious effects on their mental health, social development and education. The E-PLAYS-2 study will test an intervention ('E-PLAYS') aimed at supporting such children. E-PLAYS uses a dyadic computer game to develop collaborative and communication skills. Preliminary studies by the authors show that E-PLAYS can produce improvements in children with social communication difficulties on communication test scores and observed collaborative behaviours. The study described here is a definitive trial to test the effectiveness and cost-effectiveness of E-PLAYS delivered by teaching assistants in schools. METHODS The aim of the E-PLAYS-2 trial is to establish the effectiveness and cost-effectiveness of care as usual plus the E-PLAYS programme, delivered in primary schools, compared to care as usual. Cluster-randomisation will take place at school level to avoid contamination. The E-PLAYS intervention will be delivered by schools' teaching assistants. Teachers will select suitable children (ages 5-7 years old) from their schools using guidelines provided by the research team. Assessments will include blinded language measures and observations (conducted by the research team), non-blinded teacher-reported measures of peer relations and classroom behaviour and parent-reported use of resources and quality of life. A process evaluation will also include interviews with parents, children and teaching assistants, observations of intervention delivery and a survey of care as usual. The primary analysis will compare pragmatic language scores for children who received the E-PLAYS intervention versus those who did not at 40 weeks post-randomisation. Secondary analyses will assess cost-effectiveness and a mixed methods process evaluation will provide richer data on the delivery of E-PLAYS. DISCUSSION The aim of this study is to undertake a final, definitive test of the effectiveness of E-PLAYS when delivered by teaching assistants within schools. The use of technology in game form is a novel approach in an area where there are currently few available interventions. Should E-PLAYS prove to be effective at the end of this trial, we believe it is likely to be welcomed by schools, parents and children. TRIAL REGISTRATION ISRCTN 17561417, registration date 19th December 2022. PROTOCOL VERSION v1.1 19th June 2023.
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Affiliation(s)
- Suzanne Murphy
- University of Bedfordshire, University Square, Luton, Bedfordshire, LU1 3JU, UK.
| | - Kerry Bell
- York Trials Unit, University of York, Heslington, York, YO10 5DD, UK
| | - Erica Jane Cook
- University of Bedfordshire, University Square, Luton, Bedfordshire, LU1 3JU, UK
| | - Sarah Crafter
- Open University, Walton Hall, Kents Hill, Milton Keynes, Milton, MK7 6AA, UK
| | - Rosemary Davidson
- University of Bedfordshire, University Square, Luton, Bedfordshire, LU1 3JU, UK
| | | | - Kate Hicks
- York Trials Unit, University of York, Heslington, York, YO10 5DD, UK
| | - Victoria Joffe
- University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK
| | - David Messer
- Open University, Walton Hall, Kents Hill, Milton Keynes, Milton, MK7 6AA, UK
| | | | - Luke Strachan
- York Trials Unit, University of York, Heslington, York, YO10 5DD, UK
| | - David Torgerson
- York Trials Unit, University of York, Heslington, York, YO10 5DD, UK
| | - Charlie Welch
- York Trials Unit, University of York, Heslington, York, YO10 5DD, UK
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O'Donoghue M, Kennedy N, Forbes J, Murphy CA. Stakeholder Perceptions of the Acceptability of Peer-Mediated Intervention for Minimally Speaking Preschoolers on the Autism Spectrum. J Autism Dev Disord 2024; 54:1774-1791. [PMID: 36859610 PMCID: PMC9977098 DOI: 10.1007/s10803-023-05928-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 03/03/2023]
Abstract
Peer mediated intervention (PMI) is an evidence-based approach to supporting social and communication development for children on the autism spectrum. For PMI to be integrated into everyday practice, it needs to be acceptable to stakeholders. This article engaged with autistic individuals, early childhood educators, parents, and speech and language pathologists on the prospective acceptability of implementing PMI with minimally speaking preschoolers in inclusive preschool settings. Focus groups and semi-structured interviews were conducted. The transcriptions were analyzed qualitatively using reflexive thematic analysis. Stakeholders described PMI as an acceptable intervention approach for this population and provided valuable insights to inform the development and implementation of PMIs. Attention needs to be paid to how to support preschools to adopt a PMI-friendly philosophy.
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Affiliation(s)
- Michelle O'Donoghue
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland.
| | - Norelee Kennedy
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland
| | - John Forbes
- Graduate Entry Medical School, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Carol-Anne Murphy
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland
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Ghahramani S, Hassani Mehraban A, Alizadeh Zarei M, Ghahramani S. Occupational Therapy Outcome Measures in Preschool Children With Autism Spectrum Disorders: A Scoping Review. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024:15394492241246547. [PMID: 38682488 DOI: 10.1177/15394492241246547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
With the rising prevalence of autism spectrum disorder (ASD), early assessment of preschool children is vital for occupational therapists. This scoping review aimed to provide detailed information about outcome measures used in occupational therapy interventions in preschool children with ASD and map the focus of the outcome measures based on the International Classification of Functioning, Disability, and Health (ICF) components. A thorough search from 2000 to 2022 was conducted that employed ICF linking rules to categorize the outcome measures. Seventy-four outcome measures were identified. They predominantly targeted body function and activity/participation, with less emphasis on environmental factors, and none assessed body structure. The most common measures were Vineland Adaptive Behavior Scale (VABS-2), Canadian Occupational Performance Measure (COPM), and Parenting Stress Index-Short Form (PSI-SF). This study offers a diverse array of outcome measures and underscores the potential of the ICF framework in enhancing evaluations, particularly concerning broader environmental components as one of the primary facilitating/hindering factors in the participation of children with ASD.
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Chamberlain A, D'Arcy E, Whitehouse AJ, Wallace K, Hayden-Evans M, Girdler S, Milbourn B, Bölte S, Evans K. Reliability, Validity and Acceptability of the PEDI-CAT with ASD Scales for Australian Children and Youth on the Autism Spectrum. J Autism Dev Disord 2024:10.1007/s10803-024-06366-7. [PMID: 38678516 DOI: 10.1007/s10803-024-06366-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE The PEDI-CAT (ASD) is used to assess functioning of children and youth on the autism spectrum; however, current psychometric evidence is limited. This study aimed to explore the reliability, validity and acceptability of the PEDI-CAT (ASD) using a large Australian sample. METHODS Caregivers of 134 children and youth on the spectrum participated in clinical assessments involving the administration of the PEDI-CAT (ASD), Vineland-3, PEDI-CAT (Original) and a feedback instrument. The PEDI-CAT (ASD) content was compared to the ICF Core Sets for ASD to summarize areas of functioning assessed and relevance to autism. RESULTS The PEDI-CAT (ASD) demonstrated good to excellent internal consistency and test-re-test reliability. Parallel forms reliability with the PEDI-CAT (Original) included significant correlations (good to excellent), however, t-tests showed significantly higher Social/Cognitive scores for the ASD version. Convergent validity results demonstrated that most PEDI-CAT (ASD) and Vineland-3 core domains were significantly correlated (poor to good). Content analysis revealed that the PEDI-CAT (ASD) covered less than half of the ICF Core Sets for ASD (mostly Activities and Participation codes). Just over half the codes assigned to the PEDI-CAT (ASD) were represented in the ICF Core Sets for ASD. Feedback on the acceptability of the measure was mixed, but overall was it was considered user-friendly and efficient. CONCLUSION The PEDI-CAT (ASD) had adequate psychometric properties and acceptability as a measure of Activities and Participation codes. However, it lacks comprehensiveness and relevance when compared to the ICF Core Sets for ASD and has the potential to overestimate functioning.
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Affiliation(s)
- Angela Chamberlain
- Curtin University, Perth, Australia
- Telethon Kids Institute, Perth, Australia
- Autism CRC, Brisbane, Australia
| | - Emily D'Arcy
- Curtin University, Perth, Australia
- Telethon Kids Institute, Perth, Australia
- Autism CRC, Brisbane, Australia
| | - Andrew Jo Whitehouse
- Telethon Kids Institute, Perth, Australia
- Autism CRC, Brisbane, Australia
- Stockholm Health Care Services, Stockholm, Sweden
| | | | - Maya Hayden-Evans
- Curtin University, Perth, Australia
- Telethon Kids Institute, Perth, Australia
- Autism CRC, Brisbane, Australia
| | - Sonya Girdler
- Curtin University, Perth, Australia
- Telethon Kids Institute, Perth, Australia
- Autism CRC, Brisbane, Australia
- Karolinska Institutet, Solna, Sweden
- The University of Western Australia, Perth, Australia
| | - Benjamin Milbourn
- Curtin University, Perth, Australia
- Telethon Kids Institute, Perth, Australia
- Autism CRC, Brisbane, Australia
| | - Sven Bölte
- Curtin University, Perth, Australia
- Karolinska Institutet, Solna, Sweden
- Stockholm Health Care Services, Stockholm, Sweden
| | - Kiah Evans
- Curtin University, Perth, Australia.
- Telethon Kids Institute, Perth, Australia.
- Autism CRC, Brisbane, Australia.
- The University of Western Australia, Perth, Australia.
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Marcilla-Jorda M, Grande C, Coelho V, Rubio-Belmonte C, Moro-Ipola M. Sensory Profile-2 in Autism Spectrum Disorder: An Analysis within the International Classification of Functioning, Disability and Health Framework. J Autism Dev Disord 2024:10.1007/s10803-024-06337-y. [PMID: 38613593 DOI: 10.1007/s10803-024-06337-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2024] [Indexed: 04/15/2024]
Abstract
Autism spectrum disorder (ASD) is characterized by impairments in many functional areas requiring long-term interventions to promote autonomy. This study aims to map The Sensory Profile™ 2 (SP-2), one of the most widely used assessment tools in children with ASD, with the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY), developed by the World Health Organization (WHO). This will allow the identification of the functional dimensions covered by this instrument and the comparison with the ICF shortlist proposed for autism (ICF Core Set [ICF-CS]). The deductive content analysis described in the ICF Linking Rules was followed, along with a systematized process including statistical and reasoning techniques that could contribute to the improvement of ICF linking studies (Cohen's Kappa and percentage of agreement). 218 codes were identified, 71% of them were codes related to the body functions chapters, mainly linked to perceptual functions (b160), emotional functions (b152), and temperament and personality functions (b126). Concerning activities and participation chapters (29%) the most frequently used codes were: focusing attention (d160), carrying out daily routine (d230), and walking (d450). Even though the SP-2 items do not assess most of the functional features regarded as essential in the ASD ICF-CS, SP-2 encompasses a majority of problems concerning body functions. This instrument may be considered as part of a multidimensional assessment approach, to complement other sources that are more likely to assess activity and participation dimensions and guide a functional intervention.
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Affiliation(s)
| | - Catarina Grande
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Center for Psychology at University of Porto, University of Porto, Porto, Portugal
| | - Vera Coelho
- Department of Social and Behavioral Sciences, Universidade da Maia, Maia, Portugal
- Center for Psychology at University of Porto, University of Porto, Porto, Portugal
| | | | - Micaela Moro-Ipola
- Faculty of Health Sciences, Universitat Jaume I, Castello de la Plana, Spain.
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Byrne K, Sterrett K, Holbrook A, Kim SH, Grzadzinski R, Lord C. Extending the Usefulness of the Brief Observation of Social Communication Change (BOSCC): Validating the Phrase Speech and Young Fluent Version. J Autism Dev Disord 2024; 54:1009-1023. [PMID: 36547793 PMCID: PMC9772597 DOI: 10.1007/s10803-022-05877-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
The current study investigated the utility of the Brief Observation of Social Communication Change-Phrase Speech Young Fluent (BOSCC-PSYF) as an outcome measure of treatment response by analyzing the measure's psychometric properties and initial validity. The BOSCC coding scheme was applied to 345 administrations from 160 participants diagnosed with autism. Participants included individuals of any age with phrase speech, or individuals under the age of 8 years with complex sentences. All were receiving behavioral intervention throughout the study. Test-retest and inter-rater reliability were good for the Early Communication and Social Reciprocity/Language domains, and fair for the Restricted and Repetitive Behavior domain. Significant changes occurred over time in the Early Communication and Social Reciprocity/Language domains, and Core Total scores. The BOSCC-PSYF may provide a low-cost, flexible, and user-friendly outcome measure that reliably measures changes in broad social communicative behaviors in a short period of time.
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Affiliation(s)
| | - Kyle Sterrett
- University of California, Los Angeles, California, USA
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Gentles SJ, Ng-Cordell EC, Hunsche MC, McVey AJ, Bednar ED, DeGroote MG, Chen YJ, Duku E, Kerns CM, Banfield L, Szatmari P, Georgiades S. Trajectory research in children with an autism diagnosis: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:540-564. [PMID: 37194194 PMCID: PMC10913344 DOI: 10.1177/13623613231170280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
LAY ABSTRACT The types of outcomes studied in children on the autism spectrum include clinical characteristics, such as social functioning, communication, language, or autism symptoms. Research that measures these outcomes at multiple timepoints is useful to improve our understanding of what to expect as children develop. In trajectory studies, researchers assess outcomes at three or more timepoints. This method has advantages over two-timepoint studies because it allows researchers to describe changes in the speed of development, such as accelerations, plateaus, or slowdowns. We identified and reviewed 103 published trajectory studies in children (to age 18 years) with an autism diagnosis. Importantly, we did not include studies of treatments or their effects, nor did we summarize the results of studies. Instead, this review summarizes the characteristics of the available published research, including the methods used, the many different outcomes that have been studied over time and the ages over which they have been studied. This summary may be of interest to autistic people and caregivers (parents) who want to know about the existence of research that provides answers about what to expect during an autistic child's development. We have recommended that future trajectory research efforts try to make up for the lack of studies from low- and middle-income countries; that more attention is given to the following outcomes that are meaningful to caregivers and autistic people; and to try to fill in the age gaps where more outcome-specific data are needed.
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Sneed L, Taylor R, Cook I, Befi M, Fitchett B, Samelson D, Bemmel V. Initial Psychometric Properties of the Catalight Family Wellbeing Scale. J Autism Dev Disord 2024:10.1007/s10803-024-06254-0. [PMID: 38300503 DOI: 10.1007/s10803-024-06254-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 02/02/2024]
Abstract
PURPOSE Wellbeing refers to a person's overall happiness and satisfaction with life. Wellbeing for people with Intellectual and Developmental Disabilities (I/DD) and their families is historically significantly lower compared to the general population. It is important in the context of behavioral health treatment to not only measure the individual who is receiving treatment's overall wellbeing, but also the wellbeing of the family. The purpose of this study was to understand the initial psychometric properties of the Catalight Family Wellbeing Scale. METHODS The Catalight Family Wellbeing Scale was developed for families who have a child with I/DD. Caregivers of 3106 families who have a child with a diagnosed I/DD, including autism spectrum disorder, completed the scale as part of their onboarding for behavioral health treatment along with three other questionnaires. The psychometric properties including internal reliability and factor structure were completed as well as initial convergent and divergent validity. RESULTS Results of the analyses revealed very strong internal reliability and a three-factor structure. Validity analyses revealed a moderate positive relationship with parental self-efficacy and a moderate negative relationship with parental stress. Additionally, the sample population represents an ethnically diverse group with multiple co-occurring diagnosis in addition to I/DD. CONCLUSIONS The initial psychometric properties of the Catalight Family Wellbeing Scale are positive and support the use of the scale for families who have a child with I/DD across a diverse sample.
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Affiliation(s)
- Lindsey Sneed
- Catalight Research Institute, 2730 Shadelands Dr. Walnut Creek, Walnut Creek, CA, 94598, US.
| | - Ryan Taylor
- Catalight Research Institute, 2730 Shadelands Dr. Walnut Creek, Walnut Creek, CA, 94598, US
| | - Ian Cook
- Catalight Research Institute, 2730 Shadelands Dr. Walnut Creek, Walnut Creek, CA, 94598, US
| | - Michelle Befi
- Catalight Research Institute, 2730 Shadelands Dr. Walnut Creek, Walnut Creek, CA, 94598, US
| | - Brianna Fitchett
- Catalight Research Institute, 2730 Shadelands Dr. Walnut Creek, Walnut Creek, CA, 94598, US
| | - Doreen Samelson
- Catalight Research Institute, 2730 Shadelands Dr. Walnut Creek, Walnut Creek, CA, 94598, US
| | - Vincent Bemmel
- Catalight Research Institute, 2730 Shadelands Dr. Walnut Creek, Walnut Creek, CA, 94598, US
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Denusik L, Glista D, Servais M, Friesen J, Oram J, Cunningham BJ. "We were the best people to do the job": Caregivers' reported outcomes of a virtual caregiver-delivered program for autistic preschoolers. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2024; 9:23969415241244767. [PMID: 38694817 PMCID: PMC11062079 DOI: 10.1177/23969415241244767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
Background and aims Caregiver-delivered programs are a recommended best practice to support young autistic children. While research has extensively explored children's outcomes quantitatively, minimal qualitative research has been conducted to understand caregivers' perspectives of program outcomes for themselves and their children. Hearing directly from caregivers is an important step in ensuring these programs are meeting the needs of those who use them. This study explored caregivers' perceived outcomes following one virtual caregiver-delivered program, The Hanen Centre's More Than Words® (MTW) program. Methods This study was a secondary analysis of data from individual interviews conducted with 21 caregivers who had recently participated in a virtual MTW program. A hybrid codebook thematic analysis approach was taken to analyze the interview data. Program outcomes were coded and analyzed within the International Classification Functioning, Disability, and Health (ICF) framework. Additionally, caregivers completed an online survey and rated Likert Scale items about perceived program outcomes, which were analyzed descriptively. Results Five themes were identified: (1) caregivers learned new strategies to facilitate their child's development, (2) caregivers developed a new mindset, (3) children gained functional communication skills, (4) caregiver-child relationships improved, and (5) caregivers gained a social and professional support network. These themes fell within four of five ICF framework components (activities, participation, personal factors, and environmental factors). No themes were identified under Body Structures and Functions. Survey results indicated most caregivers reported learning new communication strategies (n = 20, 95%), and identifying new teaching opportunities with their child (n = 21, 100%). Conclusions Some reported outcomes, related to Activities and Participation, were consistent with previous reports in the literature on the MTW program. In line with previous research, caregivers learned strategies to support their child's communication development. Contrary to previous quantitative studies, caregivers in this study rarely commented on gains in vocabulary and instead focused on gains in skills that positively impacted their child's ability to engage in meaningful social interaction. Novel outcomes were identified within the Participation, Personal Factors, and Environmental Factors components of the ICF framework. Implications Caregivers in this study identified important outcomes for themselves and their child that have not been the focus of prior research, suggesting it is important to integrate their perspectives in the development and evaluation of caregiver-delivered programs. Clinicians should include goals that address outcomes identified as important by caregivers, including those that address children's Participation, and those that target caregivers' Personal and Environmental Factors. Developers of caregiver-delivered programs could integrate identified goals to ensure they are meeting families' needs.
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Affiliation(s)
- Lauren Denusik
- School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada
| | - Danielle Glista
- University of Western Ontario, London, ON, Canada
- School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada
| | | | - Jodi Friesen
- School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada
| | - Janis Oram
- School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada
| | - Barbara Jane Cunningham
- School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada
- CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
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Lichtlé J, Devouche E, Dialahy IZ, de Gaulmyn A, Amestoy A, Coutelle R, Isnard P, Monestès J, Mottron L, Cappe E. Development, psychometric evaluation, and factor analysis of an instrument measuring quality of life in autistic preschoolers. Int J Methods Psychiatr Res 2023; 33:e2002. [PMID: 38133582 PMCID: PMC10804264 DOI: 10.1002/mpr.2002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 10/06/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION Early interventions for autistic children should target their quality of life (QoL) but require adapted measures. The association of a child's temperament and parental characteristics with the QoL of autistic children remains unknown. METHODS We constructed an autism module based on a thematic analysis, a Delphi survey with experts, and a pre-test with parents to be completed alongside the proxy version of the PedsQL 4.0. We explored compliance, responsiveness, internal consistency, convergent validity, and factor structure with 157 parents of autistic preschool children. We examined the association between child and parental characteristics with the QoL of autistic children using correlation analysis, principal component analysis, hierarchical ascending classification, and linear regression. Sociodemographic information was collected via multiple choice questions, autism severity via Autism Diagnostic Observation Schedule (ADOS) scores, and parental acceptance and child's temperament via the Acceptance and Action Questionnaire and the Emotionality, Activity, and Sociability. RESULTS An autism module comprised of 27 items emerged. Psychometric evaluation resulted in a 24-item autism module with good internal consistency and significant convergent validity. ADOS total score was not significantly related to QoL, contrary to children's sleep issues, children's emotionality, and parental acceptance. CONCLUSIONS The autism module is a reliable QoL proxy measure for autistic preschool children. Results suggest parental interventions targeting children's QoL.
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Affiliation(s)
- Jérôme Lichtlé
- Université Paris CitéLaboratoire de Psychopathologie et Processus de SantéBoulogne‐BillancourtFrance
| | - Emmanuel Devouche
- Université Paris CitéLaboratoire de Psychopathologie et Processus de SantéBoulogne‐BillancourtFrance
| | - Isaora Zefania Dialahy
- Centre Intégré Universitaire de Santé et des Services Sociaux du Nord de l’île de MontréalMontréalQuébecCanada
| | - Aude de Gaulmyn
- Centre de Recherche et Diagnostic pour l'Autisme et Troubles Apparentés (CREDAT, Hôpital Sainte‐Anne GHU Paris Psychiatrie & Neurosciences)ParisFrance
| | - Anouck Amestoy
- INCIA, UMR 5287CNRS Bordeaux Neurocampus. CHCPBordeauxFrance
| | - Romain Coutelle
- Service de Psychiatrie de l'enfant et de l'adolescentHôpitaux Universitaires de StrasbourgStrasbourgFrance
- Unité INSERM 1114StrasbourgFrance
| | - Pascale Isnard
- Service de PédopsychiatrieHôpital Bichat Claude BernardAPHP. Nord Université Paris CitéParisFrance
- La Boussole PDAPHôpital Bichat Claude BernardHOVIAParisFrance
- Université Paris SaclayUVSQInserm U 1018CESPVillejuifFrance
| | | | - Laurent Mottron
- Département de Psychiatrie et d’AddictologieHôpital Rivière Des Prairies & Centre de Recherche du CIUSSS‐NIMUniversité de MontréalMontréalQuébecCanada
| | - Emilie Cappe
- Université Paris CitéLaboratoire de Psychopathologie et Processus de SantéBoulogne‐BillancourtFrance
- Institut universitaire de France (IUF)ParisFrance
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Spiegel R, Notter M, Lazari O, Schmeck K, Herbrecht E. Clinical utility of the standardized observation tool Autism Behavior Coding System for early intervention research in autism spectrum disorder. Autism Res 2023; 16:2415-2431. [PMID: 37937753 DOI: 10.1002/aur.3047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/14/2023] [Indexed: 11/09/2023]
Abstract
The Autism Behavior Coding System (ABCS) was developed to help evaluating the effectiveness of early intensive interventions in children with autism spectrum disorder (ASD). The video-based ABCS assesses eight core autistic behavioral variables during therapist-child interaction using standardized quantitative criteria, four behaviors according to their frequency of occurrence, four according to their duration. The present study focuses (1) on the correspondence of ABCS scores with scores on two standard clinical instruments (the ADOS-2 and an ASD-adaptation of the Children's Global Assessment Scale, DD-CGAS), (2) on the sensitivity to change of ABCS scores by the end of an intensive 18 days intervention period (EIP) and (c) on the predictability of short- and longer-term changes in social and repetitive behaviors from ABCS scores at baseline and EIP. Data from 51 children (42 M, 9 F; median age 45 months) followed over 1 year were available. There were significant correlations at baseline between several ABCS scores and ADOS-2 as well as DD-CGAS scores. Correlations at EIP between some ABCS and DD-CGAS scores were highly significant. Four ABCS scores reflected significant changes from baseline to EIP. Several baseline ABCS scores were predictive of DD-CGAS and ADOS-2 scores at EIP and Year 1. However, associations between ABCS score changes from baseline to EIP and the clinical scale changes by Year 1 were not significant. It is concluded that several ABCS scores have adequate clinical validity and sensitivity to change. The short-term changes in ABCS scores and their relationship to longer-term clinical changes need further study.
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Affiliation(s)
- René Spiegel
- Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Marianne Notter
- Child and Adolescent Psychiatry, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Olga Lazari
- Child and Adolescent Psychiatry, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Klaus Schmeck
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Evelyn Herbrecht
- Child and Adolescent Psychiatry, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
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Ne'eman A, Richman KA, McCarthy AM, Wilkenfeld D. A Passing Problem: Evaluating Harm and Benefit in Autism Research. Ethics Hum Res 2023; 45:2-18. [PMID: 37988276 DOI: 10.1002/eahr.500188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
Autism research frequently seeks to evaluate interventions or inform their development. Unfortunately, researchers often assume that autism intervention should reduce autistic traits, effectively setting as a goal of treatment that autistic people attempt to "pass" as nonautistic. A growing body of evidence highlights serious potential harms from passing demands. We discuss why it is important for institutional review boards (IRBs) to scrutinize autism research for clinical passing demands, and we document the existence of such demands in outcome measures commonly employed in autism research. We propose an ethical framework for IRBs and others to make use of in evaluating the ethical appropriateness of particular treatment goals in autism intervention or intervention-adjacent research, emphasizing that treatment goals should be in pursuit of a beneficial nonpassing purpose and be the least burdensome means of accomplishing such a purpose. We also highlight potential promising practices for IRBs, investigators, and other stakeholders seeking to address these issues in autism research.
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Affiliation(s)
- Ari Ne'eman
- PhD candidate in health policy at Harvard University
| | - Kenneth A Richman
- Professor of philosophy and health care ethics at the Massachusetts College of Pharmacy and Health Sciences (officially known as MCPHS University)
| | - Allison M McCarthy
- Assistant professor of psychiatry and behavioral sciences and a faculty member with the Center for Biomedical Ethics and Society at Vanderbilt University Medical Center
| | - Daniel Wilkenfeld
- Associate professor in the Department of Acute and Tertiary Care in the School of Nursing at the University of Pittsburgh
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Zhao H, Tang C, Wang M, Zhao H, Zhu Y. Ferroptosis as an emerging target in rheumatoid arthritis. Front Immunol 2023; 14:1260839. [PMID: 37928554 PMCID: PMC10620966 DOI: 10.3389/fimmu.2023.1260839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/22/2023] [Indexed: 11/07/2023] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease of unknown etiology. Due to the rise in the incidence rate of RA and the limitations of existing therapies, the search for new treatment strategies for RA has become a global focus. Ferroptosis is a novel programmed cell death characterized by iron-dependent lipid peroxidation, with distinct differences from apoptosis, autophagy, and necrosis. Under the conditions of iron accumulation and the glutathione peroxidase 4 (GPX4) activity loss, the lethal accumulation of lipid peroxide is the direct cause of ferroptosis. Ferroptosis mediates inflammation, oxidative stress, and lipid oxidative damage processes, and also participates in the occurrence and pathological progression of inflammatory joint diseases including RA. This review provides insight into the role and mechanism of ferroptosis in RA and discusses the potential and challenges of ferroptosis as a new therapeutic strategy for RA, with an effort to provide new targets for RA prevention and treatment.
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Affiliation(s)
- Hui Zhao
- The Geriatrics, Graduate School of Anhui University of Chinese Medicine, Hefei, China
| | - Cheng Tang
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Miao Wang
- The Geriatrics, Graduate School of Anhui University of Chinese Medicine, Hefei, China
| | - Hongfang Zhao
- The Geriatrics, Graduate School of Anhui University of Chinese Medicine, Hefei, China
| | - Yan Zhu
- The Geriatrics, Graduate School of Anhui University of Chinese Medicine, Hefei, China
- The Geriatrics, The Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
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Tinelli M, Roddy A, Knapp M, Arango C, Mendez MA, Cusack J, Murphy D, Canitano R, Oakley B, Quoidbach V. Economic analysis of early intervention for autistic children: findings from four case studies in England, Ireland, Italy, and Spain. Eur Psychiatry 2023; 66:e76. [PMID: 37732502 PMCID: PMC10594363 DOI: 10.1192/j.eurpsy.2023.2449] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Many autistic children experience difficulties in their communication and language skills development, with consequences for social development into adulthood, often resulting in challenges over the life-course and high economic impacts for individuals, families, and society. The Preschool Autism Communication Trial (PACT) intervention is effective in terms of improved social communication and some secondary outcomes. A previously published within-trial economic analysis found that results at 13 months did not support its cost-effectiveness. We modeled cost-effectiveness over 6 years and across four European countries. METHODS Using simulation modeling, we built on economic analyses in the original trial, exploring longer-term cost-effectiveness at 6 years (in England). We adapted our model to undertake an economic analysis of PACT in Ireland, Italy, and Spain. Data on resource use were taken from the original trial and a more recent Irish observational study. RESULTS PACT is cost-saving over time from a societal perspective, even though we confirmed that, at 13 months post-delivery, PACT is more expensive than usual treatment (across all countries) when given to preschool autistic children. After 6 years, we found that PACT has lower costs than usual treatment in terms of unpaid care provided by parents (in all countries). Also, if we consider only out-of-pocket expenses from an Irish study, PACT costs less than usual treatment. DISCUSSION PACT may be recommended as a cost-saving early intervention for families with an autistic child.
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Affiliation(s)
- Michela Tinelli
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Aine Roddy
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
- Atlantic Technological University, Sligo, Ireland
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
| | - Maria Andreina Mendez
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
| | | | | | - Roberto Canitano
- University Hospital of Siena – Azienda ospedaliero-universitaria Senese, Siena, Italy
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Ataman R, Thomas A, Roberge-Dao J, McKerral M, Auger C, Wittich W, Kengne Talla P, Boychuck Z, Ahmed S. Measurement Properties of the Mayo-Portland Adaptability Inventory (MPAI-4) and Related Measures: A Systematic Review. Arch Phys Med Rehabil 2023; 104:1300-1313. [PMID: 36708857 DOI: 10.1016/j.apmr.2022.12.196] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To assess the Mayo-Portland Adaptability Inventory-version 4 (MPAI-4) and related measures' measurement properties and the quality of evidence supporting these results; and identify the interpretability and feasibility of the MPAI-4 and related measures. DATA SOURCES We conducted a systematic review according to COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. We searched 9 electronic databases and registries, and hand searched reference lists of included articles. STUDY SELECTION Two independent reviewers screened and selected all articles. From 605 retrieved articles, 48 were included. DATA EXTRACTION Two independent reviewers appraised the evidence quality and rated the extracted classical test theory and Rasch results from each study. DATA SYNTHESIS We used meta-analysis and COSMIN's approach to synthesize measurement properties evidence (insufficient, sufficient), and the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to synthesize evidence quality (very low, low, moderate, high) by diagnosis (traumatic brain injury [TBI], stroke), and setting (inpatient, outpatient). The MPAI-4 and its subscales are sufficiently comprehensible (GRADE: very low), but there is currently no other content validity evidence (relevance, comprehensiveness). The MPAI-4 and its participation index (M2PI) have sufficient interrater reliability for stroke and TBI outpatients (GRADE: moderate), whereas interrater reliability between TBI inpatients and clinicians is currently insufficient (GRADE: moderate). There is no evidence for measurement error. For stroke and TBI outpatients, the MPAI-4 and M2PI have sufficient construct validity (GRADE: high) and responsiveness (GRADE: moderate-high). For TBI inpatients, the MPAI-4 and M2PI have mixed indeterminant/sufficient construct validity and responsiveness evidence (GRADE: moderate-high). There is 1 study with mixed insufficient/sufficient evidence for each MPAI-4 adaptation (21- and 22-item MPAI, 9-item M2PI) (GRADE: low-high). CONCLUSION Users can be most confident in using the MPAI-4 and M2PI in TBI and stroke outpatient settings. Future research is needed on reliability, measurement error, predictive validity, and content validity of the MPAI-4 and its related measures across populations and settings.
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Affiliation(s)
- Rebecca Ataman
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada; Institute of Health Sciences Education, McGill University, Montréal, Canada
| | - Jacqueline Roberge-Dao
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | - Michelle McKerral
- Department of Psychology, Université de Montréal, Montréal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal, Montréal, Canada
| | - Claudine Auger
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal, Montréal, Canada; School of Rehabilitation, Université de Montréal, Montréal, Canada
| | - Walter Wittich
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada; School of Optometry, Université de Montreal, Montréal, Canada
| | - Pascaline Kengne Talla
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada; Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montréal, Canada
| | - Zachary Boychuck
- CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada; McGill University Health Center, Clinical Epidemiology, Montréal, Canada.
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Oakley B, Boatman C, Doswell S, Dittner A, Clarke A, Ozsivadjian A, Kent R, Judd A, Baldoza S, Hearn A, Murphy D, Simonoff E. Molehill Mountain feasibility study: Protocol for a non-randomised pilot trial of a novel app-based anxiety intervention for autistic people. PLoS One 2023; 18:e0286792. [PMID: 37406026 PMCID: PMC10321642 DOI: 10.1371/journal.pone.0286792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/23/2023] [Indexed: 07/07/2023] Open
Abstract
Up to 50% of autistic people experience co-occurring anxiety, which significantly impacts their quality of life. Consequently, developing new interventions (and/ or adapting existing ones) that improve anxiety has been indicated as a priority for clinical research and practice by the autistic community. Despite this, there are very few effective, evidence-based therapies available to autistic people that target anxiety; and those that are available (e.g., autism adapted Cognitive Behavioural Therapy; CBT) can be challenging to access. Thus, the current study will provide an early-stage proof of concept for the feasibility and acceptability of a novel app-based therapeutic approach that has been developed with, and adapted for, autistic people to support them in managing anxiety using UK National Institute for Health and Care Excellence (NICE) recommended adapted CBT approaches. This paper describes the design and methodology of an ethically approved (22/LO/0291) ongoing non-randomised pilot trial that aims to enrol approximately 100 participants aged ≥16-years with an existing autism diagnosis and mild-to-severe self-reported anxiety symptoms (trial registration NCT05302167). Participants will be invited to engage with a self-guided app-based intervention-'Molehill Mountain'. Primary (Generalised Anxiety Disorder Assessment, Hospital Anxiety and Depression Scale) and secondary outcomes (medication/ service use and Goal Attainment Scaling) will be assessed at baseline (Week 2 +/- 2), endpoint (Week 15 +/- 2) and three follow-ups (Weeks 24, 32 and 41 +/- 4). Participants will also be invited to complete an app acceptability survey/ interview at the study endpoint. Analyses will address: 1) app acceptability/ useability and feasibility (via survey/ interview and app usage data); and 2) target population, performance of outcome measures and ideal timing/ duration of intervention (via primary/ secondary outcome measures and survey/ interview)-with both objectives further informed by a dedicated stakeholder advisory group. The evidence from this study will inform the future optimisation and implementation of Molehill Mountain in a randomised-controlled trial, to provide a novel tool that can be accessed easily by autistic adults and may improve mental health outcomes.
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Affiliation(s)
- Bethany Oakley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Camberwell, London, United Kingdom
| | - Charlotte Boatman
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Camberwell, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Camberwell, London, United Kingdom
| | - Sophie Doswell
- National Adult ADHD and ASD Psychology Service (NAAAPS), Behavioural & Developmental Psychiatry, Monks Orchard House, Bethlem Royal Hospital, Beckenham, Kent, United Kingdom
| | - Antonia Dittner
- National Adult ADHD and ASD Psychology Service (NAAAPS), Behavioural & Developmental Psychiatry, Monks Orchard House, Bethlem Royal Hospital, Beckenham, Kent, United Kingdom
| | | | - Ann Ozsivadjian
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Camberwell, London, United Kingdom
| | - Rachel Kent
- Michael Rutter Centre for Children & Young People, Maudsley Hospital, London, United Kingdom
| | | | | | | | - Declan Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Camberwell, London, United Kingdom
- Sackler Institute for Translational Neurodevelopment, King’s College London, Denmark Hill, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Camberwell, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
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22
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Wathen JK, Jagannatha S, Ness S, Bangerter A, Pandina G. A platform trial approach to proof-of-concept (POC) studies in autism spectrum disorder: Autism spectrum POC initiative (ASPI). Contemp Clin Trials Commun 2023; 32:101061. [PMID: 36949847 PMCID: PMC10025278 DOI: 10.1016/j.conctc.2023.101061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 11/29/2022] [Accepted: 01/14/2023] [Indexed: 01/18/2023] Open
Abstract
Background Over the past decade, autism spectrum disorder (ASD) research has blossomed, and multiple clinical trials have tested potential interventions, with varying results and no clear demonstration of efficacy. Lack of clarity concerning appropriate biological mechanisms to target and lack of sensitive, objective tools to identify subgroups and measure symptom changes have hampered the efforts to develop treatments. A platform trial for proof-of-concept studies in ASD could help address these issues. A major goal of a platform trial is to find the best treatment in the most expeditious manner, by simultaneously investigating multiple treatments, using specialized statistical tools for allocation and analysis. We describe the setup of a platform trial and perform simulations to evaluate the operating characteristics under several scenarios. We use the Autism Behavior Inventory (ABI), a psychometrically validated web-based rating scale to measure the change in ASD core and associated symptoms. Methods Detailed description of the setup, conduct, and decision-making rules of a platform trial are explained. Simulations of a virtual platform trial for several scenarios are performed to compare operating characteristics. The success and futility criteria for treatments are based on a Bayesian posterior probability model. Results Overall, simulation results show the potential gain in terms of statistical properties especially for improved decision-making ability, while careful planning is needed due to the complexities of a platform trial. Conclusions Autism research, shaped particularly by its heterogeneity, may benefit from the platform trial approach for POC clinical studies.
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Affiliation(s)
| | - Shyla Jagannatha
- Corresponding author. Janssen Research & Development, LLC 1125 Trenton-Harbourton Road Titusville NJ 08560, USA.
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23
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Wall CA, Sabatos-DeVito M, Franz L, Howard J, Major S, Bey A, Dawson G. Eye-tracking measures of social versus nonsocial attention are related to level of social engagement during naturalistic caregiver-child interactions in autistic children. Autism Res 2023; 16:1052-1062. [PMID: 36942384 DOI: 10.1002/aur.2920] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/11/2023] [Indexed: 03/23/2023]
Abstract
Eye-tracking (ET) measures indexing social attention have been proposed as sensitive measures related to autism, but less is known about the relationship between social and nonsocial attention and naturalistic measures of social engagement and whether sex moderates this relationship. This study investigated ET measures of social attention as predictors of social engagement during a naturalistic caregiver-child interaction (CCI). Participants included 132, 2-7-year-old autistic children (77% male) and their caregivers. Participants engaged in a CCI and an ET task in which they viewed a video of an actor making dyadic bids toward the child with toys in the background. Pearson correlations and multiple regression analyzes revealed that ET measures correlated with social engagement behaviors, including degree of attention to the caregiver and objects, joint engagement with the caregiver, and language-based joint engagement. Children who spent more time looking at toys were more likely to be unengaged during social interaction. Those who spent more time looking at the actor's mouth were more likely to engage in coordinated play with and without language. Sex moderated the relationship between time looking at toys and unengagement during play; males who spent more time looking at toys spent more time unengaged during play, whereas females who spent more time looking at toys spent less time unengaged during play. Overall, ET measures of social and nonsocial attention correlated with the level of social engagement during naturalistic play, with some sex differences. Eye-tracking measures that predict interaction patterns may provide insight into promoting social engagement between caregivers and their autistic children and can inform outcome monitoring and intervention development.
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Affiliation(s)
- Carla A Wall
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Maura Sabatos-DeVito
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Lauren Franz
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Jill Howard
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Samantha Major
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Alexandra Bey
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
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24
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Tomchek SD, Dean E, Baker A, Little LM, Wallisch A. Interventions to Support Participation in Education for Autistic Students (2013-2021). Am J Occup Ther 2023; 77:7710393150. [PMID: 37585656 DOI: 10.5014/ajot.2023.77s10015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each systematic review brief summarizes the evidence on a theme related to a systematic review topic. This systematic review brief presents findings from the systematic review on interventions to support autistic1 children and youth (up to 18 yr old) and focuses on participation in education settings.
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Affiliation(s)
- Scott D Tomchek
- Scott D. Tomchek, PhD, OTR/L, FAOTA, is Professor, Department of Pediatrics, Division of Developmental Behavioral Pediatrics, University of Louisville School of Medicine, Louisville, KY
| | - Evan Dean
- Evan Dean, PhD, OTR/L, is Associate Director, Beach Center on Disability, University of Kansas, Lawrence, KS
| | - Alissa Baker
- Alissa Baker, MS, OTR/L, is Instructor, Department of Occupational Therapy, Western Michigan University, Kalamazoo, MI
| | - Lauren M Little
- Lauren M. Little, PhD, OTR/L, is Associate Professor, Occupational Therapy, Rush University, Chicago, IL
| | - Anna Wallisch
- Anna Wallisch, PhD, OTR/L, is Postdoctoral Research Associate, Juniper Gardens Children's Project, University of Kansas, Lawrence, KS
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25
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Little LM, Cohen SR, Tomchek S, Baker A, Wallisch A, Dean E. Interventions to Support Participation in Play for Autistic Children and Youth (Dates of Review: 2013-2021). Am J Occup Ther 2023; 77:7710393170. [PMID: 37566777 DOI: 10.5014/ajot.2023.77s10017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
Abstract
Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each systematic review brief summarizes the evidence on a theme related to a systematic review topic. This systematic review brief presents findings to support participation in play for autistic1 children and adolescents (birth to 18 yr).
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Affiliation(s)
- Lauren M Little
- Lauren M. Little, PhD, OTR/L, is Associate Professor, Occupational Therapy, Rush University, Chicago, IL
| | - Samantha R Cohen
- Samantha R. Cohen, BA, OTS, is OTD student, Occupational Therapy, Rush University, Chicago, IL
| | - Scott Tomchek
- Scott Tomchek, PhD, OTR/L, FAOTA, is Professor, Pediatrics, University of Louisville, Louisville, KY
| | - Alissa Baker
- Alissa Baker, MS, OTR/L, is Instructor, Western Michigan University, Grand Rapids, MI
| | - Anna Wallisch
- Anna Wallisch, PhD, OTR/L, is Postdoctoral Research Associate, Juniper Gardens Children's Project, University of Kansas, Lawrence, KS
| | - Evan Dean
- Evan Dean, PhD, OTR/L, is Associate Director, Beach Center on Disability, University of Kansas, Lawrence, KS
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26
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Tomchek SD, Baker A, Little LM, Wallisch A, Dean E. Interventions to Support Participation in Sleep for Autistic Children and Adolescents (2013-2021). Am J Occup Ther 2023; 77:7710393160. [PMID: 37585657 DOI: 10.5014/ajot.2023.77s10016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each systematic review brief summarizes the evidence on a theme related to a systematic review topic. This systematic review brief presents findings from the systematic review on interventions to support participation in sleep for autistic1 children and adolescents (birth to 18 yr).
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Affiliation(s)
- Scott D Tomchek
- Scott D. Tomchek, PhD, OTR/L, FAOTA, is Professor, Department of Pediatrics, Division of Developmental Behavioral Pediatrics, University of Louisville School of Medicine, Louisville, KY
| | - Alissa Baker
- Alissa Baker, MS, OTRL, is Instructor, Department of Occupational Therapy, Western Michigan, University, Kalamazoo, MI
| | - Lauren M Little
- Lauren M. Little, PhD, OTR/L, is Associate Professor, Occupational Therapy, Rush University, Chicago, IL
| | - Anna Wallisch
- Anna Wallisch, PhD, OTR/L, is Postdoctoral Research Associate, Juniper Gardens Children's Project, University of Kansas, Lawrence, KS
| | - Evan Dean
- Evan Dean, PhD, OTR/L, is Associate Director, Beach Center on Disability, University of Kansas, Lawrence, KS
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27
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Baker A, Tomchek SD, Little LM, Wallisch A, Dean E. Interventions to Support Participation in Basic and Instrumental Activities of Daily Living for Autistic Children and Adolescents (2013-2021). Am J Occup Ther 2023; 77:7710393140. [PMID: 37562056 DOI: 10.5014/ajot.2023.77s10014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Abstract
Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each systematic review brief summarizes the evidence on a theme related to a systematic review topic. This systematic review brief presents findings from the systematic review on interventions to support participation in basic and instrumental activities of daily living by autistic1 children and adolescents (birth to 18 yr).
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Affiliation(s)
- Alissa Baker
- Alissa Baker, MS, OTRL, is Instructor, Department of Occupational Therapy, Western Michigan University, Kalamazoo, MI
| | - Scott D Tomchek
- Scott D. Tomchek, PhD, OTR/L, FAOTA, is Professor, Department of Pediatrics, Division of Developmental Behavioral Pediatrics, University of Louisville School of Medicine, Louisville, KY
| | - Lauren M Little
- Lauren M. Little, PhD, OTR/L, is Associate Professor, Occupational Therapy, Rush University, Chicago, IL
| | - Anna Wallisch
- Anna Wallisch, PhD, OTR/L, is Postdoctoral Research Associate, Juniper Gardens Children's Project, University of Kansas, Lawrence, KS
| | - Evan Dean
- Evan Dean, PhD, OTR/L, is Associate Director, Beach Center on Disability, University of Kansas, Lawrence, KS
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28
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Rutherford M, Baxter J, Johnston L, Tyagi V, Maciver D. Piloting a Home Visual Support Intervention with Families of Autistic Children and Children with Related Needs Aged 0-12. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4401. [PMID: 36901410 PMCID: PMC10001844 DOI: 10.3390/ijerph20054401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED Visual supports are an important intervention for autistic individuals and others with neurodevelopmental differences. However, families often report limited access to visual supports and lack of information and confidence in their use at home. This pilot study aimed to evaluate the feasibility and effectiveness of a home-based visual supports intervention. METHODS 29 families with children (n = 20 males; mean age 6.59 years [Range 3.64-12.21 years SD 2.57]) receiving support for autism or related needs participated in the study. Parents engaged in an individualised assessment and intervention process through home visits, completing pre- and post-measures. Qualitative methods were used to explore the parents' experiences of the intervention. RESULTS The intervention led to a statistically significant improvement in parent-reported quality of life (t28 = 3.09, p = 0.005) and parent-reported perception of autism-specific difficulties (t28 = 2.99, p = 0.006). Parents also reported improved access to resources and relevant information and increased confidence in using visual supports at home. The home visit model was strongly supported by the parents. CONCLUSION The results provide initial evidence of the acceptability, practicality, and utility of the home-based visual supports intervention. These findings suggest that outreach into the family home may be a beneficial mechanism for delivering interventions related to visual supports. This study highlights the potential of home-based interventions to improve access to resources and information for families and the importance of visual supports in the home setting.
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Affiliation(s)
- Marion Rutherford
- School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK
- NHS Lothian Speech and Language Therapy Department, Edinburgh EH16 4TJ, UK
| | - Julie Baxter
- City of Edinburgh Council, Additional Support for Learning Service, Edinburgh EH8 8BG, UK
| | - Lorna Johnston
- City of Edinburgh Council, Additional Support for Learning Service, Edinburgh EH8 8BG, UK
| | - Vaibhav Tyagi
- School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK
| | - Donald Maciver
- School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK
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29
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D'Arcy E, Evans K, Afsharnejad B, Milbourn B, Bölte S, Girdler S. Assessing functioning for individuals with neurodevelopmental conditions: Current clinical practice in Australia. Aust Occup Ther J 2023; 70:43-60. [PMID: 35934786 PMCID: PMC10087051 DOI: 10.1111/1440-1630.12834] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND In the disability sector globally, and specifically in Australia, assessments of functioning have become key to diagnostic processes, and accessing therapy and funding. Over half of all individuals accessing support through Australia's National Disability Insurance Scheme have a neurodevelopmental condition diagnosis. Little is known about assessments of functioning for this population. METHODS A mixed methods online survey was designed to understand the current assessment of functioning practices (including clinical contexts, concepts being assessed, and assessment methods) and barriers and facilitators to clinicians using best practice. Results were analysed descriptively, and differences between professions calculated where possible. Content analysis was used to explore qualitative comments. RESULTS Clinicians from various medical and allied health backgrounds completed the survey (n = 93), with varying ranges of age, experience, and education. Clinicians reported that they assessed functioning across age, setting, sector, funding body, and individuals with a wide variety of diagnoses. Missing from current practice is a clear transdisciplinary conceptualisation of functioning. The largest barriers to best practice were limited time, large caseloads, availability of appropriate tools, and lack of clarity from funding bodies. CONCLUSIONS Missing from current practice is a clear transdisciplinary conceptualisation of functioning.These results will help inform steps forward to improve assessment of functioning practices to ensure that all individuals receive appropriate and sufficient support.
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Affiliation(s)
- Emily D'Arcy
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
| | - Kiah Evans
- Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,School of Allied Health, University of Western Australia, Perth, Western Australia, Australia
| | - Bahareh Afsharnejad
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
| | - Benjamin Milbourn
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
| | - Sven Bölte
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden.,Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Sonya Girdler
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia.,School of Allied Health, University of Western Australia, Perth, Western Australia, Australia.,Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden
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30
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Trembath D, Varcin K, Waddington H, Sulek R, Bent C, Ashburner J, Eapen V, Goodall E, Hudry K, Roberts J, Silove N, Whitehouse A. Non-pharmacological interventions for autistic children: An umbrella review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:275-295. [PMID: 36081343 DOI: 10.1177/13623613221119368] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT What is already known about the topic?The delivery of evidence-based interventions is an important part of the clinical pathway for many autistic children and their families. However, parents, practitioners, and policymakers face challenges making evidence informed decisions, due to the wide variety of interventions available and the large, and often inconsistent, body of evidence regarding their effectiveness.What this paper adds?This is a comprehensive umbrella review, also known as a 'review of reviews', which examined the range of interventions available, the evidence for their effectiveness, and whether effects were influenced by factors relating to individual children (e.g. chronological age, core autism characteristics, and related skills) or the ways interventions were delivered (by whom and in what setting, format, mode, and amount). There was evidence for positive therapeutic effects for some, but not all, interventions. No single intervention had a positive effect for all child and family outcomes of interest. The influence of child and delivery characteristics on effects was unclear.Implications for practice, research, and policyThe findings provide parents, practitioners, and policymakers with a synthesis of the research evidence to inform decision-making and highlight the importance of individualised approaches in the absence of clear and consistent evidence. The findings also highlight the need to improve consistency and completeness in reporting of research studies, so that the same questions may be answered more comprehensively in the future.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Andrew Whitehouse
- Telethon Kids Institute and The University of Western Australia, Australia
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31
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Gunderson J, Worthley E, Byiers B, Symons F, Wolff J. Self and caregiver report measurement of sensory features in autism spectrum disorder: a systematic review of psychometric properties. J Neurodev Disord 2023; 15:5. [PMID: 36698071 PMCID: PMC9875408 DOI: 10.1186/s11689-022-09473-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 12/16/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Unusual responses to sensory stimuli are considered a diagnostic symptom of autism spectrum disorder with mounting research efforts put towards understanding, characterizing, and treating such symptoms. METHODS This paper examines self and caregiver report tools used to measure sensory features in ASD through a systematic review of the psychometric evidence for their use. A total of 31 empirical papers were reviewed across 20 assessment tools. Substantial differences were identified in the specific sensory features defined across assessment tools. Sensory assessment questionnaires were evaluated against quality psychometric evidence criteria to provide a use recommendation. RESULTS Five assessments were identified to be "appropriate with conditions," while no sensory assessment tools were identified to have sufficient quality psychometric evidence to provide a recommendation of "Appropriate" for measuring sensory features in ASD. CONCLUSION Evidence from this review highlights potentially significant shortcomings among the current methods used to measure sensory features in ASD and suggests the need for more efforts in developing psychometrically sound sensory assessment tools for use in ASD populations.
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Affiliation(s)
- Jaclyn Gunderson
- grid.17635.360000000419368657Department of Educational Psychology, Educational Sciences Building College of Education and Human Development, University of Minnesota, 56 River Road, Minneapolis, MN 55455 USA ,grid.66875.3a0000 0004 0459 167XDepartment of Psychiatry and Psychology, Mayo Clinic, 200 1St Street Southwest, Rochester, MN 55902 USA
| | - Emma Worthley
- grid.17635.360000000419368657Department of Educational Psychology, Educational Sciences Building College of Education and Human Development, University of Minnesota, 56 River Road, Minneapolis, MN 55455 USA
| | - Breanne Byiers
- grid.17635.360000000419368657Department of Educational Psychology, Educational Sciences Building College of Education and Human Development, University of Minnesota, 56 River Road, Minneapolis, MN 55455 USA
| | - Frank Symons
- grid.17635.360000000419368657Department of Educational Psychology, Educational Sciences Building College of Education and Human Development, University of Minnesota, 56 River Road, Minneapolis, MN 55455 USA
| | - Jason Wolff
- grid.17635.360000000419368657Department of Educational Psychology, Educational Sciences Building College of Education and Human Development, University of Minnesota, 56 River Road, Minneapolis, MN 55455 USA
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32
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Wang L, Micsinszki SK, Goulet-Barteaux M, Gilman C, Phoenix M. Youth and family engagement in childhood disability evidence syntheses: A scoping review. Child Care Health Dev 2023; 49:20-35. [PMID: 35708523 DOI: 10.1111/cch.13022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 04/12/2022] [Accepted: 06/13/2022] [Indexed: 12/15/2022]
Abstract
Within the last decade, stakeholder engagement in research has become increasingly popular in childhood disability research; however, literature on the engagement of youth with neurodisabilities and their families in evidence syntheses is underdeveloped. Involving patients as partners in research has the potential to improve applicability and relevance of the research and benefit patient partners (e.g. enhanced self-esteem, increased research knowledge and skills); however, the methods, challenges, outcomes and recommendations of engaging youth with neurodisabilities and their families in evidence syntheses are unknown. Two parents of youth with complex disability needs were engaged as partners throughout this review. Following methods outlined by Arksey and O'Malley (2005), the primary research question in this scoping review is twofold: (i) what activities have youth with neurodisabilities and their families been engaged in as part of evidence syntheses and (ii) what were the outcomes of that engagement? After full text review of 369 articles, nine articles were included. Youth and families were engaged prior to the evidence synthesis and at every stage in the project, most often during data analysis where they contextualized the findings. Youth and family engagement were not formally evaluated; however, positive outcomes were reported by parents and researchers. Challenges such as increased time, sustaining engagement, and parents' dissatisfaction with their level of involvement were reported. Recommendations centred around providing partners with information, building relationships via social media, and openly communicating about roles, feedback and logistics. Childhood disability researchers should be aware of how they can increase engagement opportunities at all stages of evidence syntheses and how they might improve accessibility for youth with neurodisabilities and their families. Further research is needed to solidify a unified framework for conduct and reporting of youth and family engagement in evidence syntheses.
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Affiliation(s)
- Lucy Wang
- McMaster University, Hamilton, Ontario, Canada
| | - Samantha K Micsinszki
- McMaster University, Hamilton, Ontario, Canada.,CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | | | - Christina Gilman
- Parents Partnering in Research, CanChild, McMaster University, Hamilton, Ontario, Canada
| | - Michelle Phoenix
- McMaster University, Hamilton, Ontario, Canada.,CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
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33
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Wilkinson EH, Britton TC, Hall SS. Examining Phenotypic Differences in Gaze Avoidance Between Autism Spectrum Disorder and Fragile X Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 127:435-454. [PMID: 36306410 PMCID: PMC9667749 DOI: 10.1352/1944-7558-127.6.435] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 08/31/2021] [Indexed: 05/22/2023]
Abstract
We examined potential phenotypic differences in eye gaze avoidance exhibited by boys with autism spectrum disorder (ASD) and boys with fragile X syndrome (FXS). In Study 1, the Eye Contact Avoidance Scale (ECAS) was administered to caregivers of boys aged 7-18 years with FXS (n = 148), ASD (n = 168), and mixed developmental disabilities (MDD; n = 128). In Study 2, subsets of boys with FXS (n = 31) and boys with ASD (n = 25) received a brief behavioral treatment probe to improve eye contact. Results showed that boys with FXS obtained significantly higher scores on the ECAS compared to boys with ASD and MDD. Exposure to the brief behavioral treatment probe resulted in significant decreases in scores for boys with FXS, but not for boys with ASD.
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Affiliation(s)
- Ellen H Wilkinson
- Ellen H. Wilkinson, Tobias C. Britton, and Scott S. Hall, Stanford University School of Medicine
| | - Tobias C Britton
- Ellen H. Wilkinson, Tobias C. Britton, and Scott S. Hall, Stanford University School of Medicine
| | - Scott S Hall
- Ellen H. Wilkinson, Tobias C. Britton, and Scott S. Hall, Stanford University School of Medicine
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34
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Sandham V, Hill AE, Hinchliffe F. The perspectives of Australian speech pathologists in providing evidence-based practices to children with autism. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2022; 57:1229-1243. [PMID: 35674484 PMCID: PMC9796017 DOI: 10.1111/1460-6984.12736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 04/28/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Bridging the research-practice gap in autism communication services is an identified priority for improving services. Limited research has investigated the views of practitioners regarding this research-practice gap. Investigation of the barriers experienced and facilitators used in clinical practice may assist to identify scalable and sustainable strategies to increase use of evidence-based practices (EBPs) in the delivery of communication services to children with autism. AIMS To elucidate how Australian speech pathologists engage with external evidence and how communication outcomes are measured to demonstrate the effectiveness of service provision to children with autism. METHODS & PROCEDURES A total of 15 Australian speech pathologists, with experience ranging from less than 1 to more than 16 years, participated in three focus groups. Data from focus groups were analysed using reflexive thematic analysis within an interpretive phenomenological paradigm. OUTCOMES & RESULTS Seven themes were identified. Participants reported on the diversity of individuals with autism, their experiences of resource constraints, seeking collegial advice and accessing a diverse range of evidence sources, the role of clinical expertise in translating evidence to practice, the barriers experienced in outcome measurement and use of stakeholders to facilitate data collection to demonstrate outcomes. CONCLUSIONS & IMPLICATIONS Individual practitioner skill and beliefs are facilitators to translating research to practice. Interventions to improve clinician use of EBP should address the skill and belief barriers, aiming to increase a clinician's EBP self-efficacy and increasing their expectation that investing in EBP activities will result in improved services for children with autism. Modelling and reflective practice are two strategies that may have an application as interventions to improve EBP use in clinical practice. WHAT THIS PAPER ADDS What is already known on the subject Constrained resources, especially lack of time, is a barrier to routine uptake of best available evidence in clinical services for children with autism. What this paper adds to existing knowledge In this study, the perception that speech pathologists lacked time to engage in EBP activities was linked with the speech pathologist's research skill and their beliefs about the benefits of engaging in EBP. Speech Pathologists reported using a range of information sources, as "evidence" but also reported feeling uneasy when using evidence of disputable, or unknown quality. Accessibility and relevance to their individual client were highly prioritised in selecting evidence. Clinical expertise was an essential skill for research translation. What are the potential or actual clinical implications of this work? Interventions which target professional beliefs and research translation capability are requisite for motivating speech pathologists to improve their use of EBP. Modelling of EBP use, individual reflective practice and collegial active listening to facilitate reflective practice, might be useful strategies which target beliefs and capability of individual speech pathologists; thereby changing their EBP use.
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Affiliation(s)
- Victoria Sandham
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQLDAustralia
| | - Anne E. Hill
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQLDAustralia
| | - Fiona Hinchliffe
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQLDAustralia
- Mater Misericordiae LtdFortitude ValleyQLDAustralia
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Hayden-Evans M, Milbourn B, D’Arcy E, Chamberlain A, Afsharnejad B, Evans K, Whitehouse AJO, Bölte S, Girdler S. An Evaluation of the Overall Utility of Measures of Functioning Suitable for School-Aged Children on the Autism Spectrum: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14114. [PMID: 36360993 PMCID: PMC9659140 DOI: 10.3390/ijerph192114114] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/25/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
A diagnosis of an autism spectrum condition (autism) provides limited information regarding an individual's level of functioning, information key in determining support and funding needs. Using the framework introduced by Arksey and O'Malley, this scoping review aimed to identify measures of functioning suitable for school-aged children on the autism spectrum and evaluate their overall utility, including content validity against the International Classification of Functioning, Disability and Health (ICF) and the ICF Core Sets for Autism. The overall utility of the 13 included tools was determined using the Outcome Measures Rating Form (OMRF), with the Adaptive Behavior Assessment System (ABAS-3) receiving the highest overall utility rating. Content validity of the tools in relation to the ICF and ICF Core Sets for Autism varied, with few assessment tools including any items linking to Environmental Factors of the ICF. The ABAS-3 had the greatest total number of codes linking to the Comprehensive ICF Core Set for Autism while the Vineland Adaptive Behavior Scales (Vineland-3) had the greatest number of unique codes linking to both the Comprehensive ICF Core Set for Autism and the Brief ICF Core Set for Autism (6-16 years). Measuring functioning of school-aged children on the spectrum can be challenging, however, it is important to accurately capture their abilities to ensure equitable and individualised access to funding and supports.
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Affiliation(s)
- Maya Hayden-Evans
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4850, Australia
| | - Benjamin Milbourn
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4850, Australia
| | - Emily D’Arcy
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4850, Australia
| | - Angela Chamberlain
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4850, Australia
| | - Bahareh Afsharnejad
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
| | - Kiah Evans
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4850, Australia
- School of Allied Health, University of Western Australia, Perth 6009, Australia
| | - Andrew J. O. Whitehouse
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4850, Australia
- School of Psychological Science, University of Western Australia, Perth 6009, Australia
| | - Sven Bölte
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, 104 31 Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, 104 31 Stockholm, Sweden
| | - Sonya Girdler
- Curtin Autism Research Group, School of Allied Health, Curtin University, Perth 6102, Australia
- Autism CRC, Long Pocket, Brisbane 4850, Australia
- School of Allied Health, University of Western Australia, Perth 6009, Australia
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, 104 31 Stockholm, Sweden
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Martínez-Medina A, Morales-Calvo S, Rodríguez-Martín V, Meseguer-Sánchez V, Molina-Moreno V. Sixteen Years since the Convention on the Rights of Persons with Disabilities: What Have We Learned since Then? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11646. [PMID: 36141926 PMCID: PMC9517366 DOI: 10.3390/ijerph191811646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
Persons with disabilities have historically been subjected to discrimination and exclusion, placing them in dangerous situations of social vulnerability. The Convention on the Rights of Persons with Disabilities, passed on the 13th of December 2006, was an important legislative landmark for valuing the rights of this population group. This study involved a bibliometric analysis of 1024 research articles published in Scopus on the social, workplace, educational, and financial inclusion of persons with disabilities since the Convention. The results show an increase in scientific production, and there is also a great deal of multi-disciplinarity, which has led to important breakthroughs for the all-encompassing inclusion of this section of the population. The most productive journals, authors, institutions, and countries, as well as the international cooperation networks, are presented here. The review concludes by setting out the main themes and trends in the research.
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Affiliation(s)
- Andrés Martínez-Medina
- Health Sciences PhD Program, Catholic University of Murcia, Campus de los Jerónimos nº135, Guadalupe, 30107 Murcia, Spain
| | - Sonia Morales-Calvo
- Department of Research and Diagnostic Methods in Education, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain
| | - Vicenta Rodríguez-Martín
- Department of Social Work and Social Services, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain
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Screening for Intellectual Disabilities and/or Autism Amongst Older Children and Young Adults: a Systematic Review of Tools for Use in Africa. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00342-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abstract
There are many well-developed screening tools for both intellectual disabilities and autism, but they may not be culturally appropriate for use within Africa. Our specific aims were to complete a systematic review to (1) describe and critically appraise short screening tools for the detection of intellectual disabilities and autism for older children and young adults, (2) consider the psychometric properties of these tools, and (3) judge the cultural appropriateness of these tools for use within Africa. Six screening tools for intellectual disabilities and twelve for autism were identified and appraised using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. We identified two screening tools which appeared appropriate for validation for use within African nations.
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Abstract
BACKGROUND Autism spectrum disorder (ASD; also known as autism) is a developmental disability that begins in childhood and is typically seen in around 1% to 2% of children. It is characterised by social communication difficulties and repetitive and restricted behaviours and routines that can have a negative impact on a child's quality of life, achievement at school, and social interactions with others. It has been hypothesised that memantine, which is traditionally used to treat dementia, may be effective in reducing the core symptoms of autism as well as some co-occurring symptoms such as hyperactivity and language difficulties. If memantine is being used to treat the core symptoms of autism, it is important to review the evidence of its effectiveness. OBJECTIVES To assess the effects of memantine on the core symptoms of autism, including, but not limited to, social communication and stereotypical behaviours. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, nine other databases and three trials registers up to February 2022. We also checked reference lists of key studies and checked with experts in the field for any additional papers. We searched for retractions of the included studies in MEDLINE, Embase, and the Retraction Watch Database. No retractions or corrections were found. SELECTION CRITERIA We included randomised controlled trials (RCTs) of any dose of memantine compared with placebo in autistic people. We also included RCTs in which only one group received memantine, but both groups received the same additional therapy (e.g. a behaviour intervention). DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were core autism symptoms and adverse effects. Secondary outcomes were language, intelligence, memory, adaptive behaviour, hyperactivity, and irritability. We used GRADE to assess certainty of evidence. MAIN RESULTS We included three RCTs (two double-blind and one single-blind) with 204 participants that examined the short-term effect (immediately postintervention) of memantine in autistic people. Two studies took place in the USA and the other in Iran. All three studies focused on children and adolescents, with a mean age of 9.40 (standard deviation (SD) 2.26) years. Most participants were male (range across studies 73% to 87%). The diagnosis of ASD was based on the Diagnostic and Statistical Manual of Mental Disorders (4th edition; 4th edition, text revision; or 5th edition). To confirm the diagnosis, one study used the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R); one used ADOS, ADI-R or the Autism Diagnostic Interview Screener; and one used the Gilliam Autism Rating Scale. Dosage of memantine was based on the child's weight and ranged from 3 mg to 15 mg per day. Comparisons Two studies examined memantine compared with placebo; in the other study, both groups had a behavioural intervention while only one group was given memantine. Risk of bias All studies were rated at high risk of bias overall, as they were at high or unclear risk of bias across all but four domains in one study, and all but two domains in the other two studies. One study was funded by Forest Laboratories, LLC, (Jersey City, New Jersey), Allergan. The study sponsor was involved in the study design, data collection (via contracted clinical investigator sites), analysis and interpretation of data, and the decision to present these results. The other two studies reported no financial support or sponsorship; though in one of the two, the study medication was an in-kind contribution from Forest Pharmaceuticals. Primary outcomes There was no clear evidence of a difference between memantine and placebo with respect to severity of core symptoms of autism, although we are very uncertain about the evidence. The standardised mean difference in autism symptoms score in the intervention group versus the control group was -0.74 standard deviations (95% confidence interval (CI) -2.07 to 0.58; 2 studies, 181 participants; very low-certainty evidence; medium effect size); lower scores indicate less severe autistic symptoms. Two studies (144 participants) recorded adverse effects that the authors deemed related to the study and found there may be no difference between memantine and placebo (odds ratio (OR) 0.64, 95% CI 0.17 to 2.39; low-certainty evidence). Secondary outcomes There may be no difference between memantine and placebo on language (2 studies, 144 participants; low-certainty evidence); memory or adaptive behaviour (1 study, 23 participants; both low-certainty evidence); or hyperactivity or irritability (1 study, 121 participants; both low-certainty evidence). AUTHORS' CONCLUSIONS It is unclear whether memantine is an effective treatment for autistic children. None of the three included trials reported on the effectiveness of memantine in adults. Further studies using rigorous designs, larger samples, longer follow-up and clinically meaningful outcome measures that are important to autistic people and their families will strengthen our knowledge of the effects of memantine in autism.
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Affiliation(s)
- Amanda Brignell
- Department of Paediatrics, Monash University, Melbourne, Australia
- Developmental Paediatrics, Monash Children's Hospital, Melbourne, Australia
- Department of Speech Pathology, Australian Catholic University, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Catherine Marraffa
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Neurodevelopment and Disability, The Royal Children's Hospital, Melbourne, Australia
| | - Katrina Williams
- Department of Paediatrics, Monash University, Melbourne, Australia
- Developmental Paediatrics, Monash Children's Hospital, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Tamara May
- Department of Paediatrics, Monash University, Melbourne, Australia
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Intensive behavioural interventions based on applied behaviour analysis (ABA) for young children with autism: A cost-effectiveness analysis. PLoS One 2022; 17:e0270833. [PMID: 35972929 PMCID: PMC9380934 DOI: 10.1371/journal.pone.0270833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 06/20/2022] [Indexed: 11/19/2022] Open
Abstract
Background The economic and social costs of autism are significant. This study evaluates the cost-effectiveness of early intensive Applied Behaviour Analysis (ABA)-based interventions for autistic pre-school children in the UK. Methods A de novo economic analysis was developed in Microsoft Excel comparing early intensive ABA-based interventions compared with treatment as usual (TAU). The analysis used 15.5-year time horizon, with costs and benefits discounted a 3.5%. The model structure was based on cohort structure to capture changes in adaptive behaviour and cognitive ability over time. The analysis was informed by an individual patient data (IPD) meta-analysis of available evidence. Results Adopting a public sector perspective, early intensive ABA-based therapies were associated with greater incremental costs and greater benefits. When pessimistic assumptions were made regarding the long-term effects of treatment incremental costs were £46,103 and incremental quality-adjusted life years (QALYs) were 0.24, resulting in an incremental cost-effectiveness ratio (ICER) of £189,122 per quality-adjusted life year (QALY). When optimistic assumptions were made about long-term effects, incremental costs were £39,233 with incremental benefits of 0.84 QALYs. The resulting ICER was £46,768 per QALY. Scenario analyses emphasised the importance of assumptions made regarding adult outcomes and type of school attended, both of which significantly affect the results of the analysis. Conclusions The results of this economic analysis suggest that early intensive ABA-based interventions are unlikely to represent value for money, based on a £20,000 to £30,000 per QALY threshold typically adopted to inform UK healthcare funding decisions. However, important gaps in the available evidence, limit the strength of the conclusions that can be drawn from the presented analysis. Further research, focusing on the trajectory of autistic children following intervention is likely to be highly beneficial to resolving some of these uncertainties.
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Hollander E, Jacob S, Jou R, McNamara N, Sikich L, Tobe R, Smith J, Sanders K, Squassante L, Murtagh L, Gleissl T, Wandel C, Veenstra-VanderWeele J. Balovaptan vs Placebo for Social Communication in Childhood Autism Spectrum Disorder: A Randomized Clinical Trial. JAMA Psychiatry 2022; 79:760-769. [PMID: 35793101 PMCID: PMC9260643 DOI: 10.1001/jamapsychiatry.2022.1717] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Importance There are no approved medications for the core symptoms of autism spectrum disorder (ASD), socialization and communication difficulties. Objective To evaluate the efficacy and safety of balovaptan, an oral selective vasopressin 1a receptor antagonist, compared with placebo in children and adolescents with ASD. Design, Setting, and Participants The aV1ation study was a randomized, double-blind, 24-week, parallel-group, placebo-controlled phase 2 trial. Between November 22, 2016, and September 3, 2019, individuals were screened and randomly assigned to treatment groups. The primary efficacy analysis population comprised participants taking age-adjusted balovaptan equivalent to a 10-mg adult dose and participants from the concurrently randomized placebo group. This multicenter trial took place across 41 sites in the US. Participants were aged 5 to 17 years with diagnosed ASD and an IQ of 70 or greater. Data were analyzed from April 8 to November 16, 2020. Interventions Participants were randomly assigned to daily 4-mg or 10-mg adult-equivalent balovaptan or placebo, until the 4-mg group was discontinued. Main Outcomes and Measures The primary end point was change from baseline on the Vineland-II two-domain composite (2DC; socialization and communication domains) score at week 24. Results Between November 2016 and September 2019, a total of 599 individuals were screened and 339 participants were randomly assigned to receive 4-mg balovaptan adult-equivalent dose (91 [26.8%]), 10-mg balovaptan adult-equivalent dose (126 [37.2%]), or placebo (122 [36.0%]). Primary analysis included 86 participants assigned to receive 10-mg balovaptan adult-equivalent dose and 81 assigned to receive placebo (mean [SD] age, 12.1 [3.4] years; 139 male participants [83.2%]). No statistically significant differences were observed between the balovaptan and placebo groups in change from baseline on the Vineland-II 2DC score at week 24 (difference in adjusted least-squares mean, -0.16; 90% CI, -2.56 to 2.23; P = .91). No improvements for balovaptan vs placebo were observed at week 24 for any secondary end points. Balovaptan was well tolerated with no emerging safety concerns. Similar proportions of participants reported adverse events (balovaptan, 66 of 86 [76.7%] vs placebo, 61 of 81 [75.3%]) and serious adverse events (balovaptan, 1 of 86 [1.2%] vs placebo, 4 of 81 [4.9%]). Conclusions and Relevance In this randomized clinical trial, balovaptan did not demonstrate efficacy in improvement of socialization and communication in this population with pediatric ASD. Balovaptan was well tolerated in children 5 years or older. Further development of robust, sensitive, and objective outcome measures may help to improve future studies in the assessment of therapies targeting communication and socialization in pediatric ASD. Trial Registration ClinicalTrials.gov Identifier: NCT02901431.
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Affiliation(s)
- Eric Hollander
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, New York
| | - Suma Jacob
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis
| | - Roger Jou
- Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Nora McNamara
- Department of Psychiatry, University Hospitals, Cleveland, Ohio
| | - Linmarie Sikich
- Department of Psychiatry and Behavioral Sciences, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | - Russell Tobe
- Nathan Kline Institute for Psychiatric Research, Orangeburg, New York
| | - Janice Smith
- F. Hoffmann-La Roche Ltd, Welwyn Garden City, United Kingdom
| | - Kevin Sanders
- F. Hoffmann-La Roche Ltd, Genentech, South San Francisco, California
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Developing Gene-Based Personalised Interventions in Autism Spectrum Disorders. Genes (Basel) 2022; 13:genes13061004. [PMID: 35741766 PMCID: PMC9222529 DOI: 10.3390/genes13061004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/18/2022] [Indexed: 02/01/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with onset in early childhood [...]
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Abstract
BACKGROUND Social interaction and social communication are among the central areas of difficulty for autistic people. Music therapy uses music experiences and the relationships that develop through them to enable communication and expression, thus attempting to address some of the core problems of autistic people. Music therapy has been applied in autism since the early 1950s, but its availability to autistic individuals varies across countries and settings. The application of music therapy requires specialised academic and clinical training which enables therapists to tailor the intervention to the specific needs of the individual. The present version of this review on music therapy for autistic people is an update of the previous Cochrane review update published in 2014 (following the original Cochrane review published in 2006). OBJECTIVES To review the effects of music therapy, or music therapy added to standard care, for autistic people. SEARCH METHODS In August 2021, we searched CENTRAL, MEDLINE, Embase, eleven other databases and two trials registers. We also ran citation searches, checked reference lists, and contacted study authors to identify additional studies. SELECTION CRITERIA All randomised controlled trials (RCTs), quasi-randomised trials and controlled clinical trials comparing music therapy (or music therapy alongside standard care) to 'placebo' therapy, no treatment, or standard care for people with a diagnosis of autism spectrum disorder were considered for inclusion. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodological procedures. Four authors independently selected studies and extracted data from all included studies. We synthesised the results of included studies in meta-analyses. Four authors independently assessed risk of bias (RoB) of each included study using the original RoB tool as well as the certainty of evidence using GRADE. MAIN RESULTS: We included 16 new studies in this update which brought the total number of included studies to 26 (1165 participants). These studies examined the short- and medium-term effect of music therapy (intervention duration: three days to eight months) for autistic people in individual or group settings. More than half of the studies were conducted in North America or Asia. Twenty-one studies included children aged from two to 12 years. Five studies included children and adolescents, and/or young adults. Severity levels, language skills, and cognition were widely variable across studies. Measured immediately post-intervention, music therapy compared with 'placebo' therapy or standard care was more likely to positively effect global improvement (risk ratio (RR) 1.22, 95% confidence interval (CI) 1.06 to 1.40; 8 studies, 583 participants; moderate-certainty evidence; number needed to treat for an additional beneficial outcome (NNTB) = 11 for low-risk population, 95% CI 6 to 39; NNTB = 6 for high-risk population, 95% CI 3 to 21) and to slightly increase quality of life (SMD 0.28, 95% CI 0.06 to 0.49; 3 RCTs, 340 participants; moderate-certainty evidence, small to medium effect size). In addition, music therapy probably results in a large reduction in total autism symptom severity (SMD -0.83, 95% CI -1.41 to -0.24; 9 studies, 575 participants; moderate-certainty evidence). No clear evidence of a difference between music therapy and comparison groups at immediately post-intervention was found for social interaction (SMD 0.26, 95% CI -0.05 to 0.57, 12 studies, 603 participants; low-certainty evidence); non-verbal communication (SMD 0.26, 95% CI -0.03 to 0.55; 7 RCTs, 192 participants; low-certainty evidence); and verbal communication (SMD 0.30, 95% CI -0.18 to 0.78; 8 studies, 276 participants; very low-certainty evidence). Two studies investigated adverse events with one (36 participants) reporting no adverse events; the other study found no differences between music therapy and standard care immediately post-intervention (RR 1.52, 95% CI 0.39 to 5.94; 1 study, 290 participants; moderate-certainty evidence). AUTHORS' CONCLUSIONS: The findings of this updated review provide evidence that music therapy is probably associated with an increased chance of global improvement for autistic people, likely helps them to improve total autism severity and quality of life, and probably does not increase adverse events immediately after the intervention. The certainty of the evidence was rated as 'moderate' for these four outcomes, meaning that we are moderately confident in the effect estimate. No clear evidence of a difference was found for social interaction, non-verbal communication, and verbal communication measured immediately post-intervention. For these outcomes, the certainty of the evidence was rated as 'low' or 'very low', meaning that the true effect may be substantially different from these results. Compared with earlier versions of this review, the new studies included in this update helped to increase the certainty and applicability of this review's findings through larger sample sizes, extended age groups, longer periods of intervention and inclusion of follow-up assessments, and by predominantly using validated scales measuring generalised behaviour (i.e. behaviour outside of the therapy context). This new evidence is important for autistic individuals and their families as well as for policymakers, service providers and clinicians, to help in decisions around the types and amount of intervention that should be provided and in the planning of resources. The applicability of the findings is still limited to the age groups included in the studies, and no direct conclusions can be drawn about music therapy in autistic individuals above the young adult age. More research using rigorous designs, relevant outcome measures, and longer-term follow-up periods is needed to corroborate these findings and to examine whether the effects of music therapy are enduring.
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Affiliation(s)
- Monika Geretsegger
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre, Bergen, Norway
| | - Laura Fusar-Poli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - Cochavit Elefant
- Department of Creative Arts Therapies, University of Haifa, Haifa, Israel
| | - Karin A Mössler
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre, Bergen, Norway
| | - Giovanni Vitale
- Child and Adolescent Neuropsychiatry, University of Naples Federico II, Naples, Italy
| | - Christian Gold
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre, Bergen, Norway
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
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D’Arcy E, Wallace K, Chamberlain A, Evans K, Milbourn B, Bölte S, Whitehouse AJO, Girdler S. Content validation of common measures of functioning for young children against the International Classification of Functioning, Disability and Health and Code and Core Sets relevant to neurodevelopmental conditions. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:928-939. [PMID: 34369196 PMCID: PMC9008546 DOI: 10.1177/13623613211036809] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
LAY ABSTRACT Young children who have developmental delay, autism, or other neurodevelopmental conditions can have difficulties doing things in different areas of their life. What they can and cannot do is called their level of functioning. There are lots of assessment measures that aim to assess functioning. But, we are not sure if these measures assess all the things we need to know about these children's functioning. Other research has identified lists of items (codes) that need to be assessed to understand functioning for young children with different neurodevelopmental conditions fully. These lists include body functions (the things a child's body or brain can do), activities and participation (the activities and tasks a child does) and environmental factors (parts of the environment that can influence functioning). In this study, we looked at the items from these lists assessed by different functioning measures to see how they compared to what should be assessed. The measures that we looked at covered 21%-57% of all the codes and 19%-63% of the codes for lists specific to different conditions. Most of the measures focused on activity and participation codes, and they rarely assessed environmental factors. Knowing which codes and how much of the lists the measures assess can help researchers, clinicians and policymakers to choose measures that are more appropriate for young children with neurodevelopmental conditions.
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Affiliation(s)
- Emily D’Arcy
- Curtin University, Australia
- Telethon Kids Institute, Australia
- Cooperative Research Centre for Living with Autism, Australia
| | | | - Angela Chamberlain
- Curtin University, Australia
- Telethon Kids Institute, Australia
- Cooperative Research Centre for Living with Autism, Australia
| | - Kiah Evans
- Curtin University, Australia
- Telethon Kids Institute, Australia
- Cooperative Research Centre for Living with Autism, Australia
- The University of Western Australia, Australia
| | - Benjamin Milbourn
- Curtin University, Australia
- Telethon Kids Institute, Australia
- Cooperative Research Centre for Living with Autism, Australia
| | - Sven Bölte
- Curtin University, Australia
- Karolinska Institutet, Sweden
- Stockholm Health Care Services, Region Stockholm, Sweden
| | - Andrew JO Whitehouse
- Telethon Kids Institute, Australia
- Cooperative Research Centre for Living with Autism, Australia
- The University of Western Australia, Australia
| | - Sonya Girdler
- Curtin University, Australia
- Telethon Kids Institute, Australia
- Cooperative Research Centre for Living with Autism, Australia
- Karolinska Institutet, Sweden
- The University of Western Australia, Australia
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Alves ALC, de Paula JJ, de Miranda DM, Romano-Silva MA. The Autism Spectrum Quotient in a sample of Brazilian adults: analyses of normative data and performance. Dement Neuropsychol 2022; 16:244-248. [PMID: 35720649 PMCID: PMC9173798 DOI: 10.1590/1980-5764-dn-2021-0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/26/2021] [Accepted: 12/11/2021] [Indexed: 11/21/2022] Open
Abstract
Autism spectrum disorder (ASD) is characterized by difficulties in social interaction and inflexible behaviors/interests. To quantify ASD traits in adults with preserved intelligence, the Autism Spectrum Quotient (AQ) was developed, which is a self-report instrument and one of the most used and recommended tools.
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Affiliation(s)
- Ana Luíza Costa Alves
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Medicina Molecular, Belo Horizonte MG, Brazil
| | - Jonas Jardim de Paula
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Medicina Molecular, Belo Horizonte MG, Brazil
| | - Débora Marques de Miranda
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Medicina Molecular, Belo Horizonte MG, Brazil
| | - Marco Aurélio Romano-Silva
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Medicina Molecular, Belo Horizonte MG, Brazil
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Knowledge and Attitudes toward Autism Spectrum Disorder in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063648. [PMID: 35329335 PMCID: PMC8950846 DOI: 10.3390/ijerph19063648] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/12/2022] [Accepted: 03/17/2022] [Indexed: 11/17/2022]
Abstract
Aims: The diagnosis of autism spectrum disorder (ASD) is not easy as there is no direct test that exists to establish such a diagnosis. Increasing community and healthcare professional knowledge of the ASD spectrum is crucial because it will encourage parents of ASD children to seek screening and diagnosis from a specialist, allowing for better early detection and treatment. This study explored the knowledge of the general population in Saudi Arabia regarding ASD and assessed variables associated with an accurate understanding of ASD. Methods: A total of 769 participants were involved in this cross-sectional study, which was conducted in Saudi Arabia between November 2021 and February 2022 using an online survey tool to explore the knowledge of the general population in Saudi Arabia regarding typical child development and ASD. A binary logistic regression analysis was used to determine factors affecting participants’ knowledge of autism. Results: Overall, the study participants showed a weak level of knowledge about autism with a mean score of 5.9 (SD: 3.1), comprising 34.7% of the total maximum obtainable score. Participants with a middle income category of 5000–7500 SR are less likely to be knowledgeable about autism compared to others (OR: 0.60 (95% CI: 0.39–0.92)) (p-value = 0.020). Conclusion: The participants in our study showed limited knowledge about autism. Government funds should be made available to facilitate educational services for ASD children. More funding and resources should be allocated by the government to provide assistance for children with special needs, and changes in public facilities are required to meet the demands of ASD patients. Through an informed educational effort, various media platforms should assist in improving the community’s understanding of ASD and their attitude toward ASD patients. Educational campaigns should focus on enhancing the public’s knowledge about ASD treatment and etiology.
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Community Knowledge about Autism Spectrum Disorder in the Kingdom of Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063438. [PMID: 35329125 PMCID: PMC8954906 DOI: 10.3390/ijerph19063438] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/03/2022] [Accepted: 03/09/2022] [Indexed: 11/17/2022]
Abstract
Objectives: To explore the knowledge of the general community in Saudi Arabia about autism spectrum disorder. Method: A cross-sectional study was conducted for the period between June and September 2021 in Saudi Arabia using an online questionnaire tool. The questionnaire tool was developed based on a literature review. The questionnaire tool consists of 34 items that assess knowledge about autism spectrum disorder in terms of its etiology, autistic patient features, autistic children’s abilities and needs, and autistic adults’ abilities and needs. The total score for each subscale was used to define the level of knowledge of it. Correct answers were given a score of one, and the total score for each subscale was used to describe the level of knowledge of it. Logistic regression was used to identify predictors of good knowledge about autism spectrum disorder (defined as a total score equal or above the mean score of the study participants). Results: This study enlisted the participation of 500 people. The participants’ overall understanding of autism spectrum disorder was moderate, with a mean score of 20.6 (SD: 5.6) out of 34, or 60.6%. The participants’ knowledge levels ranged from 32.2% to 77.5%. The items about the abilities and needs of adolescents and young people with autism had the highest degree of knowledge (77.5%). The items about autism’s causes had the lowest level of expertise (32.2%). When compared to others, females, those with a master’s degree, and those working in the healthcare field had a higher likelihood of knowing more about the autism spectrum condition. (p ≤ 0.05). Conclusion: Knowledge about autism spectrum disorder in Saudi Arabia is moderate. Social media channels and healthcare centers should be used to conduct educational campaigns for parents. The goal of this educational campaign should be to improve parents’ ability to recognize the causes of autism.
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47
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Ronen GM, Rosenbaum PL, Streiner DL. Patient perspectives in pediatric neurology: a critical shift in the paradigm of outcome measurement. Dev Med Child Neurol 2022; 64:149-155. [PMID: 34091886 DOI: 10.1111/dmcn.14954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 01/19/2023]
Abstract
This review explores children's self-reported outcome measurements in pediatric neurology. We examine the following questions: (1) What is meant by patient-reported health, functioning, and quality of life outcomes? (2) How can patients express whether the interventions they receive do more good than harm? (3) Why and how should pediatric neurology patients help determine the outcomes of interest? (4) What tools and recommendations are available to evaluate the outcomes of interest? Applying patients' perspectives across the processes of evaluation of medical interventions has become an important expectation. These developments, consistent with current healthcare goals, coincide with the evolution of pediatric neurology into a sophisticated diagnostic-interventional field that aims to prolong survival, decrease impairments and symptoms, and improve patients' well-being - the recognized essential endpoints of interest in all medicine.
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Affiliation(s)
- Gabriel M Ronen
- Department of Pediatrics, CanChild Centre for Childhood Disability Research, Institute for Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Peter L Rosenbaum
- Department of Pediatrics, CanChild Centre for Childhood Disability Research, Institute for Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - David L Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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48
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Lord C, Charman T, Havdahl A, Carbone P, Anagnostou E, Boyd B, Carr T, de Vries PJ, Dissanayake C, Divan G, Freitag CM, Gotelli MM, Kasari C, Knapp M, Mundy P, Plank A, Scahill L, Servili C, Shattuck P, Simonoff E, Singer AT, Slonims V, Wang PP, Ysrraelit MC, Jellett R, Pickles A, Cusack J, Howlin P, Szatmari P, Holbrook A, Toolan C, McCauley JB. The Lancet Commission on the future of care and clinical research in autism. Lancet 2022; 399:271-334. [PMID: 34883054 DOI: 10.1016/s0140-6736(21)01541-5] [Citation(s) in RCA: 258] [Impact Index Per Article: 129.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/13/2022]
Affiliation(s)
| | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Paul Carbone
- Department of Pediatrics at University of Utah, Salt Lake City, UT, USA
| | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | | | - Themba Carr
- Rady Children's Hospital San Diego, Encinitas, CA, USA
| | - Petrus J de Vries
- Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | | | | | | | | | | | - Peter Mundy
- University of California, Davis, Davis, CA, USA
| | | | | | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | | | - Emily Simonoff
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Vicky Slonims
- Evelina Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Paul P Wang
- Simons Foundation Autism Research Initiative, Simons Foundation, New York, NY, USA; Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | | | - Rachel Jellett
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Andrew Pickles
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Patricia Howlin
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peter Szatmari
- Holland Bloorview Kids Rehabilitation Hospital, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
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Cervantes PE, Conlon GR, Shalev RA, Castellanos FX. Trends in ASD Pharmacological Research: An Analysis of ClinicalTrials.gov. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-021-00297-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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50
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Binns AV, Cunningham BJ, Andres A, Oram Cardy J. Current practices, supports, and challenges in speech-language pathology service provision for autistic preschoolers. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2022; 7:23969415221120768. [PMID: 36382071 PMCID: PMC9620702 DOI: 10.1177/23969415221120768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background Speech-language pathology services are among the most frequently accessed services for young autistic children. Therefore, understanding the nature of these services, what challenges these clinicians face, and what supports they value is critical for developing appropriate policies and practices that can maximize positive outcomes for children and families. This study had two primary aims. The first was to examine the self-reported assessment and intervention practices of community-based Speech Language Pathologists (SLPs) and communicative disorders assistants (CDAs; who provide services under the supervision of a SLP) in supporting preschool children with suspected and diagnosed autism. The second aim was to identify barriers and supports (facilitators) to providing services in the community using the Consolidated Framework for Implementation Research (CFIR) as a framework. Methods A cross-sectional online survey was used to collect qualitative and quantitative data from clinicians in Ontario Canada who were providing speech and language services to preschool children with suspected or diagnosed autism. Quantitative data were used to describe clinicians" practices, and qualitative data captured their perspectives on barriers and supports to providing services. Results A total of 258 clinicians participated in the survey. On average, clinicians reported almost half of the preschoolers on their caseload had either diagnosed or suspected autism. There was consistency across the skill development areas assessed by SLPs, and targeted during therapy sessions, with the top four areas targeted being: foundational social communication, language, play and pragmatics. However, there was wide variation in speech and language assessment and intervention practices reported by this sample of clinicians (i.e., service delivery models, tools or programs used, length and duration of therapy services, level of collaboration with other professionals). Clinicians identified several barriers to providing services: limited funding and time, lack of inter-professional collaboration, difficulty accessing services, community messaging about autism services, family readiness and clinician knowledge. Supports (facilitators) included: access to autism-focused professional development, inter- and intra-professional collaboration, and access to additional supports in the community.
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Affiliation(s)
- Amanda V Binns
- Bloorview Research Institute, Holland Bloorview
Kids Rehabilitation Hospital, Toronto, Ontario, Canada; School of
Communication Sciences and Disorders, Western University, London, Ontario,
Canada; The Institute for Education Research, University Health Network,
Toronto, Ontario, Canada
| | - Barbara Jane Cunningham
- School of Communication Sciences and Disorders,
University of Western Ontario, London, Canada; CanChild, McMaster
University, Hamilton, Ontario, Canada
| | - Allison Andres
- Communication Sciences and Disorders, University of Western
Ontario, London, Canada
| | - Janis Oram Cardy
- Communication Sciences and Disorders, University of Western
Ontario, London, Canada
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