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Uzonyi TE, Grissom AC, Anderson RV, Lee H, Towner-Wright S, Crais ER, Watson LR, Landa RJ. Scoping review of behavioral coding measures used to evaluate parent responsiveness of children with autism or elevated risk of autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:1856-1875. [PMID: 36802822 DOI: 10.1177/13623613231152641] [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: 02/19/2023]
Abstract
LAY ABSTRACT The topic of how parents react (e.g., how they talk and act) to their child with autism or elevated likelihood of autism, often called parent responsiveness, has been studied by researchers for over 50 years. Many methods for measuring behaviors around parent responsiveness have been created depending on what researchers were interested in discovering. For example, some include only the behaviors that the parent does/says in reacting to something the child does/says. Other systems look at all behaviors in a period of time between child and parent (e.g., who talked/acted first, how much the child or parent said/did). The purpose of this article was to provide a summary of how and what researchers looked at around parent responsiveness, describe the strengths and barriers of these approaches, and suggest a "best practices" method of looking at parent responsiveness. The model suggested could make it more possible to look across studies to compare study methods and results. The model could be used in the future by researchers, clinicians, and policymakers to provide more effective services to children and their families.
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Affiliation(s)
- Thelma E Uzonyi
- Kennedy Krieger Institute, USA
- The University of Tennessee Health Science Center, USA
| | | | | | - Helen Lee
- University of Southern California, USA
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2
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Effectiveness of caregiver-mediated intervention: a pilot study for children with neurodevelopmental disorders. Prim Health Care Res Dev 2022; 23:e63. [PMID: 36239147 PMCID: PMC9641652 DOI: 10.1017/s1463423622000524] [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] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Caregiver-mediated intervention (CMI), based on parent skills training, is a family-mediated intervention model for children with neurodevelopmental disorders, in particular autism spectrum disorder. This study aimed to evaluate the effectiveness of CMI. METHODS Thirty-three children (aged 22-69 months from our department) and their caregivers participated in a two-week training course of ten 90-minute lessons. Caregivers were encouraged to try their best to apply intervention skills in both home routines and play routines to encourage the development of cognition, motion, social adaptability, and behavior of children. Demographic information, video-recorded data, and diagnostic scales were collected at two key time points: baseline and post-training (PT - within six months). RESULTS Three aspects were assessed - primary variables, secondary variables, and correlation analyses. Results showed an improvement in PT in (1) Adult/Child Interaction Fidelity Rating (P < 0.01) and (2) adaptability of Gesell Developmental Scale and stereotyped behaviors and limited interests of Autism Diagnostic Observation Schedule (P < 0.05, P < 0.01). Moreover, a negative correlation occurred between caregiver skill improvement and parent education (P < 0.05), but without correlations with other demographics. CONCLUSIONS As an efficacious family intervention for both children and their caregivers, CMI is worth being generalized widely.
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Gabbay-Dizdar N, Ilan M, Meiri G, Faroy M, Michaelovski A, Flusser H, Menashe I, Koller J, Zachor DA, Dinstein I. Early diagnosis of autism in the community is associated with marked improvement in social symptoms within 1-2 years. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1353-1363. [PMID: 34623179 PMCID: PMC9340129 DOI: 10.1177/13623613211049011] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT It is widely believed that early diagnosis and treatment of autism spectrum disorder is essential for better outcome. This is demonstrated by the American Academy of Pediatrics recommendation to screen all 1.5-2.5-year-old toddlers for autism spectrum disorder. However, multiple longitudinal studies of children diagnosed with autism spectrum disorder at 1.5-6 years of age and treated in community settings have not reported any associations between earlier diagnosis and improved outcome in core autism spectrum disorder symptoms. In this study, we measured changes in core autism spectrum disorder symptoms over a 1-2-year period in 131 children diagnosed with autism spectrum disorder at 1.2-5 years of age, and treated in the community. The results revealed that children who were diagnosed before 2.5 years of age were three times more likely to exhibit considerable improvements in social autism spectrum disorder symptoms in comparison to children diagnosed at later ages. These results highlight the importance of early diagnosis and treatment of autism spectrum disorder even in community settings with heterogeneous services. In addition, these results motivate further prioritization of universal screening for autism spectrum disorder before 2.5 years of age.
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Affiliation(s)
| | - Michal Ilan
- Ben-Gurion University of the Negev, Israel.,Soroka University Medical Center, Israel
| | - Gal Meiri
- Ben-Gurion University of the Negev, Israel.,Soroka University Medical Center, Israel
| | - Michal Faroy
- Ben-Gurion University of the Negev, Israel.,Soroka University Medical Center, Israel
| | - Analya Michaelovski
- Ben-Gurion University of the Negev, Israel.,Soroka University Medical Center, Israel
| | - Hagit Flusser
- Ben-Gurion University of the Negev, Israel.,Soroka University Medical Center, Israel
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Waddington H, Reynolds JE, Macaskill E, Curtis S, Taylor LJ, Whitehouse AJ. The effects of JASPER intervention for children with autism spectrum disorder: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:2370-2385. [PMID: 34348479 DOI: 10.1177/13623613211019162] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Naturalistic developmental behavioural interventions are promising approaches for young children with, or suspected of having, autism spectrum disorder. Joint attention, symbolic play, engagement and regulation intervention (JASPER) is a well-researched naturalistic developmental behavioural intervention but, to date, no reviews have specifically evaluated its effects. This systematic literature review examined the effects of JASPER intervention and its components on child, parent and educator outcomes. Of the 96 articles screened, 19 were eligible for inclusion in the review. Most studies found that children who received JASPER intervention showed significantly greater improvements in at least one outcome related to child joint attention, joint engagement, play skills and language skills compared to the comparison group. Implementation outcomes for parents and educators were generally positive. There were no consistent predictors or mediators of treatment effects. None of the studies met all of the quality indicators outlined by the Council of Exceptional Children, and the majority of outcome measures were classified as proximal. Overall, JASPER intervention appears promising in improving child outcomes directly targeted during treatment. More research is needed to determine whether it is also effective in improving a wider range of outcomes for children with autism spectrum disorder.Lay abstractInterventions which are delivered in natural contexts and use both developmental and behavioural techniques may be helpful for children with, or suspected of having, autism spectrum disorder. Joint attention, symbolic play, engagement and regulation (JASPER) is a type of intervention, which falls under this category. Although several studies have examined the effects of JASPER, this has not yet been summarised in a review. This systematic literature review examined the effects of JASPER intervention, and the techniques that make up JASPER, on child, parent and educator outcomes. We screened 96 articles and, of these, 19 were included in the review. Most studies found that children who received JASPER intervention showed significantly greater improvements in at least one outcome related to child joint attention, joint engagement, play skills, and language skills compared to children who did not receive JASPER intervention. Parents and educators were mostly able to use the JASPER techniques. There were no consistent child, parent, teacher or treatment characteristics that influenced the effects of the JASPER intervention. None of the studies met all of the indicators of being a good quality study outlined by the Council of Exceptional Children. Overall, JASPER intervention appears promising in improving child outcomes directly targeted during treatment. More research is needed to determine whether it is also effective in improving a wider range of outcomes for children with autism spectrum disorder.
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Affiliation(s)
| | | | | | | | | | - Andrew Jo Whitehouse
- Telethon Kids Institute, Australia.,The University of Western Australia, Australia
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Harrop C, Sterrett K, Shih W, Landa R, Kaiser A, Kasari C. Short-term trajectories of restricted and repetitive behaviors in minimally verbal children with autism spectrum disorder. Autism Res 2021; 14:1789-1799. [PMID: 33960125 PMCID: PMC11045260 DOI: 10.1002/aur.2528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 03/15/2021] [Accepted: 04/14/2021] [Indexed: 11/12/2022]
Abstract
Very little is known about the 30% of children with Autism Spectrum Disorder (ASD) who remain minimally verbal when they enter school. Restricted and repetitive behaviors (RRBs) are well-characterized in younger, preschool, and toddler samples. However, the prevalence and impact of RRBs has not been characterized in older, minimally verbal children. The goal of this study was to characterize this core diagnostic feature in minimally verbal children with ASD ages 5-8 years over a 9-month period to better understand how these behaviors manifest in this crucially understudied population. RRBs were coded from caregiver-child interactions (CCX) at four timepoints. Upon entry into the study, children demonstrated an average of 17 RRBs during a 10-min CCX. The most common category was Verbal. RRBs remained constant over 6 months; however, a slight reduction was observed at the final timepoint. Compared to prior literature on younger samples, minimally verbal children with ASD demonstrated higher rates of RRBs and higher rates of verbal RRBs. Further work is required to understand the function and impact of RRBs in minimally verbal children. LAY ABSTRACT: Approximately one-third of children with autism spectrum disorder (ASD) remain minimally verbal at the time of school entry. In this study, we sought to characterize the presence of restricted and repetitive behaviors (RRBs) in school-aged children (5-8) who were minimally verbal. Compared to prior studies, minimally verbal children with ASD had higher frequencies of RRBs and demonstrated a different profile of behaviors, including more verbal RRBs.
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Affiliation(s)
- Clare Harrop
- University of North Carolina at Chapel Hill, Allied Health Sciences, Carr Mill, Mall Carrboro, NC, 27510
| | - Kyle Sterrett
- University of California Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, 90024
| | - Wendy Shih
- University of California Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, 90024
| | - Rebecca Landa
- Kennedy Krieger Institute, Center for Autism and Related Disorders, Baltimore, MD, 21211
| | - Ann Kaiser
- Vanderbilt University, Department of Special Education, Nashville, TN, 37203
| | - Connie Kasari
- University of California Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, 90024
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Grzadzinski R, Donovan K, Truong K, Nowell S, Lee H, Sideris J, Turner-Brown L, Baranek GT, Watson LR. Sensory Reactivity at 1 and 2 Years Old is Associated with ASD Severity During the Preschool Years. J Autism Dev Disord 2021; 50:3895-3904. [PMID: 32157566 DOI: 10.1007/s10803-020-04432-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Children with Autism Spectrum Disorder (ASD) often display atypical sensory reactivity within the first years of life, prior to a diagnosis. This study examined sensory reactivity patterns at 14 months, changes from 14 to 23 months, and later ASD severity at 3 to 5 years of age in children (n = 87) at elevated likelihood of ASD. Results indicated that observed hyporeactivity at 14 months and increases from 14 to 23 months were related to higher ASD severity during the preschool years. Parent report of hyperreactivity at 14 months was associated with higher ASD severity in the RRB domain during the preschool years. Early hypo and hyperreactivity may predict later severity of ASD and aid in subtyping and developing individualized treatments.
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Affiliation(s)
- Rebecca Grzadzinski
- University of North Carolina, Carolina Institute for Developmental Disabilities, Chapel Hill, NC, USA.
| | - Kevin Donovan
- University of North Carolina, Department of Biostatistics, Chapel Hill, NC, USA
| | - Kinh Truong
- University of North Carolina, Department of Biostatistics, Chapel Hill, NC, USA
| | - Sallie Nowell
- University of North Carolina, Frank Porter Graham Child Development Institute, Chapel Hill, NC, USA
| | - Helen Lee
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - John Sideris
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | | | - Grace T Baranek
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Linda R Watson
- University of North Carolina, Division of Speech and Hearing Sciences, Chapel Hill, NC, USA
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Klein CB, Swain DM, Vibert B, Clark-Whitney E, Lemelman AR, Giordano JA, Winter J, Kim SH. Implementation of Video Feedback Within a Community Based Naturalistic Developmental Behavioral Intervention Program for Toddlers With ASD: Pilot Study. Front Psychiatry 2021; 12:763367. [PMID: 34925094 PMCID: PMC8674462 DOI: 10.3389/fpsyt.2021.763367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/26/2021] [Indexed: 11/24/2022] Open
Abstract
Video feedback (VF) is an intervention delivery technique that complements naturalistic developmental behavioral interventions (NDBI) and parent-mediated interventions (PMI) by using caregiver-child interaction videos reviewed with a clinician to facilitate behavioral change in caregivers. Although VF has been implemented in PMI with young children with ASD, examinations of feasibility and acceptability, as well as the potential effectiveness of VF in community settings, have been limited. In this pilot randomized control trial (NCT03397719; https://clinicaltrials.gov/ct2/show/NCT03397719), families were randomized into a state-funded Early Intervention (EI) NDBI program or the NDBI program augmented with VF. Results demonstrated high levels of implementation and acceptability of VF augmenting the community-based EI program in caregivers and clinicians. Both groups showed significant improvements after 6 months in social communication symptoms and some areas of developmental and adaptive skills. Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT03397719, identifier: NCT03397719.
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Affiliation(s)
- Claire B Klein
- Center for Autism and the Developing Brain, Weill Cornell Medicine, White Plains, NY, United States
| | - Deanna M Swain
- Center for Autism and the Developing Brain, Weill Cornell Medicine, White Plains, NY, United States
| | - Bethany Vibert
- Autism Center, Child Mind Institute, New York, NY, United States
| | - Elysha Clark-Whitney
- Center for Autism and the Developing Brain, Weill Cornell Medicine, White Plains, NY, United States
| | - Amy R Lemelman
- Center for Autism and the Developing Brain, Weill Cornell Medicine, White Plains, NY, United States.,NewYork-Presbyterian Hospital, White Plains, NY, United States
| | | | - Jamie Winter
- NewYork-Presbyterian Hospital, White Plains, NY, United States
| | - So Hyun Kim
- Center for Autism and the Developing Brain, Weill Cornell Medicine, White Plains, NY, United States
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Ogourtsova T, O'Donnell M, De Souza Silva W, Majnemer A. Health coaching for parents of children with developmental disabilities: a systematic review. Dev Med Child Neurol 2019; 61:1259-1265. [PMID: 30883717 DOI: 10.1111/dmcn.14206] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2019] [Indexed: 11/28/2022]
Abstract
AIM To determine the level of evidence on the effectiveness of health coaching for parents of children with disabilities. METHOD A systematic review approach, comprised of a comprehensive, librarian-guided literature search; transparent study selection and data extraction; quality assessment; and synthesis of sufficiently similar data (per population, intervention nature, and overall level of evidence for each outcome using standard definitions) was undertaken. RESULTS Twenty-eight studies (13 randomized clinical trials) were included. Three health coaching approaches were identified: child-targeted (most commonly applied), parent-targeted, and a mixed approach. Overall, there is an insufficient-to-limited level of evidence regarding the effectiveness of these approaches. INTERPRETATION High-quality clinical trials using the parent-targeted coaching approach are warranted. WHAT THIS PAPER ADDS Health coaching parents of children with disabilities is an emergent practice. Child-targeted, parent-targeted, or mixed health coaching approaches exist. The child-targeted health coaching approach is currently most applied. Parents of children with autism spectrum disorder are the most common recipients.
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Affiliation(s)
- Tatiana Ogourtsova
- Department of Pediatrics, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada.,School of Physical and Occupational Therapy, McGill University Faculty of Medicine, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Center, Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Maureen O'Donnell
- Department of Pediatrics, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada.,Child Health BC, Vancouver, British Columbia, Canada
| | - Wagner De Souza Silva
- Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Annette Majnemer
- School of Physical and Occupational Therapy, McGill University Faculty of Medicine, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Center, Montreal Children's Hospital, Montreal, Quebec, Canada
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Trembath D, Gurm M, Scheerer NE, Trevisan DA, Paynter J, Bohadana G, Roberts J, Iarocci G. Systematic review of factors that may influence the outcomes and generalizability of parent‐mediated interventions for young children with autism spectrum disorder. Autism Res 2019; 12:1304-1321. [DOI: 10.1002/aur.2168] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 06/10/2019] [Indexed: 12/25/2022]
Affiliation(s)
- David Trembath
- Menzies Health Institute QueenslandGriffith University Southport Queensland Australia
| | - Mandeep Gurm
- Department of PsychologySimon Fraser University Burnaby British Columbia Canada
| | - Nichole E. Scheerer
- Department of PsychologySimon Fraser University Burnaby British Columbia Canada
| | - Dominic A. Trevisan
- Faculty of EducationSimon Fraser University Burnaby British Columbia Canada
- Child Study CenterYale University New Haven Connecticut
| | - Jessica Paynter
- Menzies Health Institute QueenslandGriffith University Southport Queensland Australia
| | - Gal Bohadana
- Menzies Health Institute QueenslandGriffith University Southport Queensland Australia
| | - Jacqueline Roberts
- Griffith Institute for Educational ResearchGriffith University Mount Gravatt, Queensland Australia
| | - Grace Iarocci
- Department of PsychologySimon Fraser University Burnaby British Columbia Canada
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Jacques C, Courchesne V, Meilleur AAS, Mineau S, Ferguson S, Cousineau D, Labbe A, Dawson M, Mottron L. What interests young autistic children? An exploratory study of object exploration and repetitive behavior. PLoS One 2018; 13:e0209251. [PMID: 30596684 PMCID: PMC6312372 DOI: 10.1371/journal.pone.0209251] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 12/03/2018] [Indexed: 11/26/2022] Open
Abstract
Behaviors characterized as restricted and repetitive (RRBs) in autism manifest in diverse ways, from motor mannerisms to intense interests, and are diagnostically defined as interfering with functioning. A variety of early autism interventions target RRBs as preoccupying young autistic children to the detriment of exploration and learning opportunities. In an exploratory study, we developed a novel stimulating play situation including objects of potential interest to autistic children, then investigated repetitive behaviors and object explorations in 49 autistic and 43 age-matched typical young children (20-69 months). Autistic children displayed significantly increased overall frequency and duration of repetitive behaviors, as well as increased specific repetitive behaviors. However, groups did not significantly differ in frequency and duration of overall object explorations, in number of different objects explored, or in explorations of specific objects. Exploratory analyses found similar or greater exploration of literacy-related objects in autistic compared to typical children. Correlations between repetitive behaviors and object explorations (their frequency and duration) revealed positive, not negative, associations in both groups. Our findings, from a novel situation incorporating potential autistic interests, suggest that RRBs do not necessarily displace exploration and its possibilities for learning in autism.
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Affiliation(s)
- Claudine Jacques
- Psychoeducation and Psychology Department, Université du Québec en Outaouais, Gatineau, Québec, Canada
- Autism Research Group, CIUSSS du Nord-de-l’île-de-Montréal, Montréal, Québec, Canada
| | - Valérie Courchesne
- Autism Research Group, CIUSSS du Nord-de-l’île-de-Montréal, Montréal, Québec, Canada
| | | | - Suzanne Mineau
- Autism Research Group, CIUSSS du Nord-de-l’île-de-Montréal, Montréal, Québec, Canada
| | - Stéphanie Ferguson
- Autism Research Group, CIUSSS du Nord-de-l’île-de-Montréal, Montréal, Québec, Canada
| | - Dominique Cousineau
- Development Center, Centre Hospitalier Universitaire Ste-Justine, Montréal, Québec, Canada
| | | | - Michelle Dawson
- Autism Research Group, CIUSSS du Nord-de-l’île-de-Montréal, Montréal, Québec, Canada
| | - Laurent Mottron
- Autism Research Group, CIUSSS du Nord-de-l’île-de-Montréal, Montréal, Québec, Canada
- Psychiatry Department, Université de Montréal, Montréal, Québec, Canada
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