51
|
Fossum KL, Williams L, Garon N, Bryson SE, Smith IM. Pivotal response treatment for preschoolers with autism spectrum disorder: Defining a predictor profile. Autism Res 2017; 11:153-165. [PMID: 28861936 DOI: 10.1002/aur.1859] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 07/24/2017] [Accepted: 08/14/2017] [Indexed: 12/22/2022]
Abstract
Behavioral characteristics of children with autism spectrum disorder (ASD) who respond positively to Pivotal Response Treatment (PRT) have been described previously, based on single-subject design research. The present study examined several such characteristics, as well as positive affect, as predictors of expressive language (EL) gains in a representative sample of preschoolers with ASD (n = 57) enrolled in a PRT-based community early intervention program. Children's cognitive ability, positive affect, and levels of appropriate toy contact measured at the start of intervention each contributed significantly to the prediction of EL outcomes. Together these variables accounted for 40% of the total outcome variance. In addition, a profile of increased EL ability, positive affect and appropriate toy contact, and decreased social avoidance and stereotyped and repetitive vocalizations was associated with greater gains during intervention. Results are discussed in relation to their implications for understanding both the variable treatment response documented in children with ASD and how to tailor treatment to optimize individual benefit. Autism Res 2018, 11: 153-165. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY The study examined behavior of 57 preschoolers who made the greatest and least gains from 1 year of a community Pivotal Response Treatment program. Using pre-treatment videos, we saw that children who made the most progress showed more language, positive affect, and appropriate interactions with toys, also less avoidance of people and fewer repetitive vocalizations. Behavior profiles can be used to match treatment to individual children's needs.
Collapse
Affiliation(s)
- Kristin-Lee Fossum
- Department of Psychology & Neuroscience, Dalhousie University, PO Box 15000 Halifax, NS, B3H 4R2, Canada
| | - Loriann Williams
- Department of Psychology & Neuroscience, Dalhousie University, PO Box 15000 Halifax, NS, B3H 4R2, Canada
| | - Nancy Garon
- Department of Psychology, Mount Allison University, 49A York Street, Sackville, NB, E4L 1C7, Canada
| | - Susan E Bryson
- Department of Pediatrics, Dalhousie University, Autism Research Centre, IWK Health Centre, PO Box 9700, Halifax, NS, B3J 6R8, Canada
| | - Isabel M Smith
- Department of Pediatrics, Dalhousie University, Autism Research Centre, IWK Health Centre, PO Box 9700, Halifax, NS, B3J 6R8, Canada
| |
Collapse
|
52
|
Ogilvie E, McCrudden MT. Evaluating the Social Validity of the Early Start Denver Model: A Convergent Mixed Methods Study. J Autism Dev Disord 2017; 47:2899-2910. [DOI: 10.1007/s10803-017-3214-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
53
|
Caron V, Bérubé A, Paquet A. Implementation evaluation of early intensive behavioral intervention programs for children with autism spectrum disorders: A systematic review of studies in the last decade. EVALUATION AND PROGRAM PLANNING 2017; 62:1-8. [PMID: 28189054 DOI: 10.1016/j.evalprogplan.2017.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 12/02/2016] [Accepted: 01/13/2017] [Indexed: 05/22/2023]
Abstract
UNLABELLED For young children with autism spectrum disorders, one of the choice interventions is Early Intensive Behavioral Intervention. Over the past ten years, its effectiveness has been abundantly evaluated based on various parameters, including the intensity and duration of the intervention. Despite major advances in effectiveness evaluation, data concerning the implementation of the intervention are often described briefly, and the active ingredients of the intervention are but rarely linked to the documented effects. OBJECTIVES This study aims at reviewing with a systematic method, the studies pertaining to EIBI provided to children with autism spectrum disorders over the past ten years (2005-2015) and at documenting the program implementation components described in the studies, based on Dane and Schneider's (1998) model in accordance with PRISMA guidelines. RESULTS The results show that, although the variables related to intervention dosage and protocol are relatively well described, the authors do not always consider them in the effects analysis. Furthermore, the majority of the studies did not report information on intervention participation, differentiation or quality. CONCLUSIONS Data concerning the implementation of the intervention are partially described in the articles retained. In this regard, a better description of the intervention provided and a more systematic evaluation of its implementation seem necessary to detect the subtle differences in the effects of the intervention.
Collapse
Affiliation(s)
- Valérie Caron
- Université du Québec à Trois-Rivières, Département de psychoéducation, 3351 Boulevard des Forges, Trois-Rivières, QC G9A 5H7, Canada.
| | - Annie Bérubé
- Université du Québec en Outaouais, Département de psychoéducation, Pavillon Alexandre Taché, 283 Boulevard Alexandre-Taché, Gatineau, QC J9A 1L8, Canada.
| | - Annie Paquet
- Université du Québec à Trois-Rivières, Département de psychoéducation, 3351 Boulevard des Forges, Trois-Rivières, QC G9A 5H7, Canada.
| |
Collapse
|
54
|
Shire SY, Chang YC, Shih W, Bracaglia S, Kodjoe M, Kasari C. Hybrid implementation model of community-partnered early intervention for toddlers with autism: a randomized trial. J Child Psychol Psychiatry 2017; 58:612-622. [PMID: 27966784 DOI: 10.1111/jcpp.12672] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Interventions found to be effective in research settings are often not as effective when implemented in community settings. Considering children with autism, studies have rarely examined the efficacy of laboratory-tested interventions on child outcomes in community settings using randomized controlled designs. METHODS One hundred and thirteen children with autism enrolled in public early intervention classrooms in low resource neighborhoods were randomized to Joint Attention, Symbolic Play, Engagement, and Regulation (JASPER) intervention or treatment as usual waitlist for 10 weeks with 1-month follow-up. RESULTS Teaching assistants delivered JASPER at adequate fidelity. Children randomized to JASPER demonstrated significant gains over treatment as usual in core developmental outcomes of joint engagement, joint attention, and play skills that were maintained at follow-up. CONCLUSIONS Supervised teaching assistants delivered JASPER intervention with a range of toddlers with autism leading to significant gains in developmental outcomes.
Collapse
Affiliation(s)
| | - Ya-Chih Chang
- California State University Los Angeles, Los Angeles, CA, USA
| | - Wendy Shih
- University of California Los Angeles, Los Angeles, CA, USA
| | | | - Maria Kodjoe
- New York Center for Child Development, New York City, NY, USA
| | - Connie Kasari
- University of California Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
55
|
Franz L, Chambers N, von Isenburg M, de Vries PJ. Autism spectrum disorder in sub-saharan africa: A comprehensive scoping review. Autism Res 2017; 10:723-749. [PMID: 28266791 PMCID: PMC5512111 DOI: 10.1002/aur.1766] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 01/17/2017] [Accepted: 01/30/2017] [Indexed: 12/18/2022]
Abstract
Autism spectrum disorder (ASD) is recognized as a global public health concern, yet almost everything we know about ASD comes from high-income countries. Here we performed a scoping review of all research on ASD ever published in sub-Saharan Africa (SSA) in order to identify ASD knowledge gaps in this part of the world. Fifty-three publications met inclusion criteria. Themes included the phenotype, genetics and risk factors for ASD in SSA, screening and diagnosis, professional knowledge, interventions for ASD, parental perceptions, and social-cognitive neuroscience. No epidemiological, early intervention, school-based or adult studies were identified. For each identified theme, we aimed to summarize results and make recommendations to fill the knowledge gaps. The quality of study methodologies was generally not high. Few studies used standardized diagnostic instruments, and intervention studies were typically small-scale. Overall, findings suggest a substantial need for large-scale clinical, training, and research programmes to improve the lives of people who live with ASD in SSA. However, SSA also has the potential to make unique and globally-significant contributions to the etiology and treatments of ASD through implementation, interventional, and comparative genomic science. Autism Res 2017, 10: 723-749. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Lauren Franz
- Division of Child and Family Mental Health and Developmental Neuroscience, Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Nola Chambers
- Division of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | | | - Petrus J de Vries
- Division of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
56
|
Colombi C, Narzisi A, Ruta L, Cigala V, Gagliano A, Pioggia G, Siracusano R, Rogers SJ, Muratori F. Implementation of the Early Start Denver Model in an Italian community. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 22:126-133. [PMID: 29110508 DOI: 10.1177/1362361316665792] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Identifying effective, community-based specialized interventions for young children with autism spectrum disorder is an international clinical and research priority. We evaluated the effectiveness of the Early Start Denver Model intervention in a group of young children with autism spectrum disorder living in an Italian community compared to a group of Italian children who received treatment as usual. A total of 22 young children diagnosed with autism spectrum disorder received the Early Start Denver Model in a center-based context for 6 h per week over 6 months. The Early Start Denver Model group was compared to a group of 70 young children diagnosed with autism spectrum disorder who received treatment as usual for an average of 5.2 h over 6 months. Children in both groups improved in cognitive, adaptive, and social skills after 3 months and 6 months of treatment. Children in the Early Start Denver Model group made larger gains in cognitive and social skills after 3 and 6 months of treatment. The Early Start Denver Model group made larger gains in adaptive skills after 3 months of treatment. Our results are discussed in terms of implications for intervention research and clinical practice. Our study supports the positive impact of the Early Start Denver Model in a non-English-speaking community.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Filippo Muratori
- 2 IRCCS Stella Maris Foundation, Italy.,6 University of Pisa, Italy
| | | |
Collapse
|
57
|
Ozturk Y, Vivanti G, Uljarevic M, Dissanayake C. Treatment-related changes in children's communication impact on maternal satisfaction and psychological distress. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 56:128-138. [PMID: 27295207 DOI: 10.1016/j.ridd.2016.05.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 05/25/2016] [Accepted: 05/26/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Parents of children with autism have been found to have reduced psychological well-being that has usually been linked to the stress related to managing their child's symptoms. As children's behavior and cognitive functioning are subject to change when suitable early intervention programs are put in place, it is plausible that positive treatment-related changes in the child will have a positive impact on parental distress. AIMS We undertook an individual differences study to investigate whether maternal psychological distress is affected by the outcomes of children receiving intervention. METHODS AND PROCEDURES The participants comprised 43 mothers of preschool children with ASD enrolled in an early intervention program for 12 months. OUTCOME AND RESULTS Child and family factors were linked to maternal psychological distress. However treatment-related changes in children's communication, as assessed on the Vineland Adaptive Behavior Scales II, and parenting satisfaction uniquely contributed to psychological distress above and beyond other factors. A mediation analysis indicated that mothers whose children make treatment gains in communication skills experience lower levels of psychological distress as a consequence of higher levels of parenting satisfaction. CONCLUSIONS AND IMPLICATIONS The findings highlight improvements in everyday adaptive communication skills in children with ASD impact on mothers' satisfaction and distress.
Collapse
Affiliation(s)
- Yagmur Ozturk
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Giacomo Vivanti
- AJ Drexel Autism Institute, Drexel University, Philadelphia, United States
| | - Mirko Uljarevic
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Melbourne, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Melbourne, Australia.
| |
Collapse
|
58
|
Yang S, Paynter JM, Gilmore L. Vineland Adaptive Behavior Scales: II Profile of Young Children with Autism Spectrum Disorder. J Autism Dev Disord 2016; 46:64-73. [PMID: 26231205 DOI: 10.1007/s10803-015-2543-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Adaptive behaviour is a crucial area of assessment for individuals with Autism Spectrum Disorder (ASD). This study examined the adaptive behaviour profile of 77 young children with ASD using the Vineland-II, and analysed factors associated with adaptive functioning. Consistent with previous research with the original Vineland a distinct autism profile of Vineland-II age equivalent scores, but not standard scores, was found. Highest scores were in motor skills and lowest scores were in socialisation. The addition of the Autism Diagnostic Observation Schedule calibrated severity score did not contribute significant variance to Vineland-II scores beyond that accounted for by age and nonverbal ability. Limitations, future directions, and implications are discussed.
Collapse
Affiliation(s)
- Sabrina Yang
- Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
| | - Jessica M Paynter
- AEIOU Foundation, PO Box 226, Nathan, QLD, 4111, Australia. .,Mater Research Institute - UQ, Level 3 Aubigny Place Raymond Terrace, South Brisbane, QLD, 4101, Australia.
| | - Linda Gilmore
- Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
| |
Collapse
|
59
|
Can biological components predict short-term evolution in Autism Spectrum Disorders? A proof-of-concept study. Ital J Pediatr 2016; 42:70. [PMID: 27448796 PMCID: PMC4957293 DOI: 10.1186/s13052-016-0281-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 07/13/2016] [Indexed: 12/04/2022] Open
Abstract
Background The clinical and pathogenetic heterogeneity of Autism Spectrum Disorders (ASD) limits our ability to predict its short- and long-term evolution. Aim of this naturalistic study was to observe the clinical evolution of very young children with ASD for 12 months after first diagnosis, in order to identify those children who might develop a more positive trajectory and understand how a wide range of biological, clinical and familial factors can influence prognosis. Methods Ninety-two children were characterized in terms of family history, prenatal and perinatal variables, and clinical conditions. The sample was divided into four subgroups based on the association of 22 biological, clinical and family history variables. Developmental Quotient (DQ), determined using the Psychoeducational Profile Revised (PEP-R), and symptoms severity, measured by means of the Autism Diagnostic Observation Schedule (ADOS), were evaluated at baseline (T0) and after one year (T1), while receiving treatment as usual. Changes in DQ and ADOS between baseline and follow-up and differences in the short-term evolution of the four subgroups were analyzed. Results At T1, 55.4 % of the children demonstrated some gains either of autistic symptomatology or of developmental skills. Mean ADOS score was 13.63 ± 3.67 at T0 and 10.85 ± 4.10 at T1 and mean DQ was 0.64 ± 0.14 at T0 and 0.66 ± 0.15 at T1. At follow-up, 33.7 % of the children showed an improvement in DQ and 37 % presented a less severe symptomatology, measured by means of ADOS. Overall, 15.2 % of the sample displayed major improvements both on developmental quotient and ADOS severity score; these children presented less EEG abnormalities and familial psychiatric disorders. The four subgroups, based on biological, clinical and familial variables, showed differing trends in terms of evolution. Conclusions Categorizing very young children with ASD in terms of biological, clinical and familial variables can be instrumental in predicting short-term evolution. This exploratory study highlights the importance of a precise characterization and thorough analysis of interactions among biological and clinical variables, in order to predict the developmental evolution in children with ASD.
Collapse
|
60
|
Hampton LH, Kaiser AP. Intervention effects on spoken-language outcomes for children with autism: a systematic review and meta-analysis. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:444-463. [PMID: 27120988 DOI: 10.1111/jir.12283] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 03/02/2016] [Accepted: 03/15/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Although spoken-language deficits are not core to an autism spectrum disorder (ASD) diagnosis, many children with ASD do present with delays in this area. Previous meta-analyses have assessed the effects of intervention on reducing autism symptomatology, but have not determined if intervention improves spoken language. This analysis examines the effects of early interventions on spoken-language in children with ASD. METHOD A systematic review of 1756 studies of children with ASD who participated in early intervention resulted in the inclusion of 26 studies in the current review. These studies included 1738 participants with ASD who were, on average, 3.3 years old (SD = 0.91). RESULTS This random-effects meta-analysis of spoken-language outcomes for children with ASD who received early intervention as compared with usual treatments yielded a significant overall mean effect size of g = 0.26 (CI = 0.11 to 0.42). On average, children with ASD significantly increased their use of spoken-language following experimental early interventions. Treatments delivered simultaneously by a clinician and a parent resulted in greater gains in spoken-language than treatments delivered by a clinician or parent only. No other participant or study characteristics predicted individual-study effect sizes. CONCLUSIONS Early intervention improves spoken-language outcomes for children with ASD, and the largest effects are found when both parent and clinician implement the intervention. Recommendations for practice include adding systematic parent training to interventions for spoken language to potentially improve outcomes. Future research should report standard language measures as well as child (cognitive ability and socio-economic status) and intervention characteristics to improve evidence related to the effects of interventions on spoken communication in children with ASD.
Collapse
Affiliation(s)
| | - A P Kaiser
- Vanderbilt University, Nashville, TN, USA
| |
Collapse
|
61
|
Guastella AJ, Hickie IB. Oxytocin Treatment, Circuitry, and Autism: A Critical Review of the Literature Placing Oxytocin Into the Autism Context. Biol Psychiatry 2016; 79:234-42. [PMID: 26257243 DOI: 10.1016/j.biopsych.2015.06.028] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 06/10/2015] [Accepted: 06/26/2015] [Indexed: 12/28/2022]
Abstract
Observed impairment in reciprocal social interaction is a diagnostic hallmark of autism spectrum disorders. There is no effective medical treatment for these problems. Psychological treatments remain costly, time intensive, and developmentally sensitive for efficacy. In this review, we explore the potential of oxytocin-based therapies for social impairments in autism. Evidence shows that acute oxytocin administration improves numerous markers critical to the social circuitry underlying social deficits in autism. Oxytocin may optimize these circuits and enhance reward, motivation, and learning to improve therapeutic outcomes. Despite this, the current evidence of therapeutic benefit from extended oxytocin treatment remains very limited. We highlight complexity in crossing from the laboratory to the autism clinical setting in evaluation of this therapeutic. We discuss a clinical trial approach that provides optimal opportunity for therapeutic response by using personalized methods that better target specific circuitry to define who will obtain benefit, at what stage of development, and the optimal delivery approach for circuitry manipulation. For the autism field, the therapeutic challenges will be resolved by a range of treatment strategies, including greater focus on specific interventions, such as oxytocin, that have a strong basis in the fundamental neurobiology of social behavior. More sophisticated and targeted clinical trials utilizing such approaches are now required, placing oxytocin into the autism context.
Collapse
Affiliation(s)
- Adam J Guastella
- Autism Clinic for Translational Research, Brain & Mind Research Institute, Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, Australia.
| | - Ian B Hickie
- Autism Clinic for Translational Research, Brain & Mind Research Institute, Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, Australia
| |
Collapse
|
62
|
Supporting Children with Autism Spectrum Disorder at Primary School: Are the Promises of Early Intervention Maintained? CURRENT DEVELOPMENTAL DISORDERS REPORTS 2016. [DOI: 10.1007/s40474-016-0069-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
63
|
Effectiveness of the Early Start Denver Model: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2016. [DOI: 10.1007/s40489-015-0068-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
64
|
Devescovi R, Monasta L, Mancini A, Bin M, Vellante V, Carrozzi M, Colombi C. Early diagnosis and Early Start Denver Model intervention in autism spectrum disorders delivered in an Italian Public Health System service. Neuropsychiatr Dis Treat 2016; 12:1379-84. [PMID: 27366069 PMCID: PMC4913966 DOI: 10.2147/ndt.s106850] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Early diagnosis combined with an early intervention program, such as the Early Start Denver Model (ESDM), can positively influence the early natural history of autism spectrum disorders. This study evaluated the effectiveness of an early ESDM-inspired intervention, in a small group of toddlers, delivered at low intensity by the Italian Public Health System. METHODS Twenty-one toddlers at risk for autism spectrum disorders, aged 20-36 months, received 3 hours/wk of one-to-one ESDM-inspired intervention by trained therapists, combined with parents' and teachers' active engagement in ecological implementation of treatment. The mean duration of treatment was 15 months. Cognitive and communication skills, as well as severity of autism symptoms, were assessed by using standardized measures at pre-intervention (Time 0 [T0]; mean age =27 months) and post-intervention (Time 1 [T1]; mean age =42 months). RESULTS Children made statistically significant improvements in the language and cognitive domains, as demonstrated by a series of nonparametric Wilcoxon tests for paired data. Regarding severity of autism symptoms, younger age at diagnosis was positively associated with greater improvement at post-assessment. CONCLUSION Our results are consistent with the literature that underlines the importance of early diagnosis and early intervention, since prompt diagnosis can reduce the severity of autism symptoms and improve cognitive and language skills in younger children. Particularly in toddlers, it seems that an intervention model based on the ESDM principles, involving the active engagement of parents and nursery school teachers, may be effective even when the individual treatment is delivered at low intensity. Furthermore, our study supports the adaptation and the positive impact of the ESDM entirely sustained by the Italian Public Health System.
Collapse
Affiliation(s)
- Raffaella Devescovi
- Division of Child Neurology and Psychiatry, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Alice Mancini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Maura Bin
- Division of Child Neurology and Psychiatry, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Valerio Vellante
- Division of Child Neurology and Psychiatry, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Marco Carrozzi
- Division of Child Neurology and Psychiatry, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Costanza Colombi
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
| |
Collapse
|
65
|
Ryberg KH. Evidence for the Implementation of the Early Start Denver Model for Young Children With Autism Spectrum Disorder. J Am Psychiatr Nurses Assoc 2015; 21:327-37. [PMID: 26511434 DOI: 10.1177/1078390315608165] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND The Early Start Denver Model (ESDM) is a manualized comprehensive therapy for toddlers with autism spectrum disorder. It emphasizes interpersonal engagement through synchrony, rhythms, and reciprocity to decrease symptom severity and accelerate cognitive, social-emotional, and language development. OBJECTIVE To systematically review evidence regarding the use of the ESDM as an intervention for young children with autism spectrum disorder. DESIGN PubMed, Scopus, Web of Science, Embase, and CINAHL were searched from 2010-2015 using predetermined inclusion criteria. Study methodology, participant characteristics, and outcomes were evaluated and quality of evidence was assigned. RESULTS Eight articles met inclusion criteria and consisted of two randomized controlled trials, four controlled trials, and two observational cohort studies. Evidence quality ranged from low to high. CONCLUSIONS The ESDM is an effective intervention that improves cognition, language, and adaptive behavior. ESDM strategies delivered in community group settings and in the home by parents have potential to be efficacious and feasible.
Collapse
Affiliation(s)
- Kayce H Ryberg
- Kayce H. Ryberg, MSN, RN, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
66
|
Shannon RA. A Clinical Translation of the Article Titled "Evidence for the Implementation of the Early Start Denver Model for Young Children With Autism Spectrum Disorder". J Am Psychiatr Nurses Assoc 2015; 21:338-42. [PMID: 26511435 DOI: 10.1177/1078390315612263] [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] [Indexed: 11/16/2022]
Abstract
The purpose of this article is to offer a clinical translation of a literature review titled "Evidence for the Implementation of the Early Start Denver Model for Young Children With Autism Spectrum Disorder" by Ryberg (2015). The literature review was conducted to determine the strength of the research evidence regarding the effectiveness of the Early Start Denver Model in improving cognitive, language, and behavioral functioning of children with autism spectrum disorder. In an effort to narrow the gap between evidence and practice, this clinical translation will discuss the components of the literature review in terms of its rationale for and objectives, methods, results, and implications for evidence-based nursing practice.
Collapse
Affiliation(s)
- Robin Adair Shannon
- Robin Adair Shannon, MS, RN, NCSN, University of Illinois College of Nursing, Chicago, IL, USA
| |
Collapse
|
67
|
Le modèle de Denver (Early Start Denver Model). Une approche d’intervention précoce pour les troubles du spectre autistique. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.neurenf.2015.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|