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Ryan AK, Miller L, Rose TA, Johnston LM. Child-led goal setting and evaluation tools for children with a disability: A scoping review. Dev Med Child Neurol 2024. [PMID: 38760984 DOI: 10.1111/dmcn.15959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/25/2024] [Accepted: 04/22/2024] [Indexed: 05/20/2024]
Abstract
AIM To examine child-led goal setting and evaluation tools and approaches for children with a disability or developmental delay. METHOD Six databases were searched for studies that included population (children aged less than 18 years with disability or developmental delay); construct (child-led goal setting tool or approach); and context (developmental therapy or rehabilitation). The utility of tools and approaches across the goal setting and evaluation process was investigated using abductive content analysis. RESULTS Fifty articles met the inclusion criteria. Three approaches and four tools for child-led goal setting and evaluation were identified. No studies reported the clinimetric properties of tools specifically for child self-respondents. Qualitative analysis revealed six distinct goal phases in which tools and approaches were used, which were synthesized into a new framework for child-led goal setting and evaluation titled DECIDE: Direct children to goal setting; Elicit goal topics and priorities; Construct a goal statement; Indicate baseline goal performance; Develop an action plan to address the goal; and Evaluate goal progress after the intervention. INTERPRETATION Children actively participated in goal setting and evaluation across six DECIDE goal phases. Further clinimetric information is required to support use of goal setting and evaluation tools with child self-respondents. Future research should emphasize the development of multi-phase goal setting tools and approaches for diverse populations of children.
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Affiliation(s)
- Aisling K Ryan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Laura Miller
- School of Allied Health, Australian Catholic University, Brisbane, Queensland, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Leanne M Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Children's Health Queensland Hospital and Health Services, Brisbane, Queensland, Australia
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Afsharnejad B, Black MH, Falkmer M, Bölte S, Girdler S. The Methodological Quality and Intervention Fidelity of Randomised Controlled Trials Evaluating Social Skills Group Programs in Autistic Adolescents: A Systematic Review and Meta-analysis. J Autism Dev Disord 2024; 54:1281-1316. [PMID: 36681732 PMCID: PMC10981608 DOI: 10.1007/s10803-023-05893-z] [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] [Accepted: 01/02/2023] [Indexed: 01/22/2023]
Abstract
A systematic review and meta-analysis were utilised to explore the methodological quality, program fidelity, and efficacy of social skills group programs (SSGPs) aiming to support autistic adolescents in navigating their everyday social worlds. The study evaluated the methodological quality and theoretical fidelity of studies, with a random effect meta-analysis conducted to summarise the overall efficacy of SSGP and its effect on social communication and interaction, behavioural/emotional challenges, adaptive functioning, and autism characteristics. Although findings from the 18 identified studies indicated an adjusted medium overall effect with these programs successfully supporting autistic adolescents' socialisation needs (g = 0. 60, p < 0.001), most studies demonstrated medium to low program fidelity despite their good methodological quality. Given the significant heterogeneity of SSGPs and variations in the design and measurement frameworks of efficacy studies, understanding the generalisability of the findings of this research is unclear.
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Affiliation(s)
- Bahareh Afsharnejad
- School of Allied Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia.
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia.
| | - Melissa H Black
- School of Allied Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia
- Division of Neuropsychiatry, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Marita Falkmer
- School of Education and Communication, CHILD, Swedish Institute for Disability Research, Jönköping University, Jönköping, Sweden
| | - Sven Bölte
- School of Allied Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia
- Division of Neuropsychiatry, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Sonya Girdler
- School of Allied Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia
- Division of Neuropsychiatry, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- School of Allied Health, University of Western Australia, Perth, WA, Australia
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Gerber AH, Kang E, Nahmias AS, Libsack EJ, Simson C, Lerner MD. Predictors of Treatment Response to a Community-Delivered Group Social Skills Intervention for Youth with ASD. J Autism Dev Disord 2023; 53:3741-3754. [PMID: 35904648 DOI: 10.1007/s10803-022-05559-2] [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] [Accepted: 03/25/2022] [Indexed: 10/16/2022]
Abstract
Group social skills interventions (GSSIs) are among the most commonly used treatments for improving social competence in youth with ASD, however, results remain variable. The current study examined predictors of treatment response to an empirically-supported GSSI for youth with ASD delivered in the community (Ntotal=75). Participants completed a computer-based emotion recognition task and their parents completed measures of broad psychopathology, ASD symptomatology, and social skills. We utilized generalized estimating equations in an ANCOVA-of-change framework to account for nesting. Results indicate differential improvements in emotion recognition by sex as well as ADHD-specific improvements in adaptive functioning. Youth with both co-occurring anxiety and ADHD experienced iatrogenic effects, suggesting that SDARI may be most effective for youth with ASD without multiple co-occurring issues. Findings provide important directions for addressing variability in treatment outcomes for youth with ASD.
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Affiliation(s)
- Alan H Gerber
- Department of Psychology, Stony Brook University, 11794-2500, Stony Brook, New York, United States
| | - Erin Kang
- Department of Psychology, Stony Brook University, 11794-2500, Stony Brook, New York, United States
- Department of Psychology, Montclair State University, Little Falls, New Jersey, United States
| | - Allison S Nahmias
- Department of Psychiatry and Behavioral Health, School of Medicine, Stony Brook University, Stony Brook, New York, United States
| | - Erin J Libsack
- Department of Psychology, Stony Brook University, 11794-2500, Stony Brook, New York, United States
| | - Caitlin Simson
- Department of Psychology, Stony Brook University, 11794-2500, Stony Brook, New York, United States
| | - Matthew D Lerner
- Department of Psychology, Stony Brook University, 11794-2500, Stony Brook, New York, United States.
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Gunawardena H, Voukelatos A, Nair S, Cross S, Hickie IB. Efficacy and Effectiveness of Universal School-Based Wellbeing Interventions in Australia: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6508. [PMID: 37569048 PMCID: PMC10418788 DOI: 10.3390/ijerph20156508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/17/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023]
Abstract
The World Health Organisation defines health in terms of wellbeing, and wellbeing has become both a construct and a measure of impact in early intervention and prevention programs in schools. In Australia, schools report on their wellbeing initiatives and there is a plethora of government-funded wellbeing programs already in place in schools. However, education systems and stakeholders worldwide are facing significant challenges with mixed evaluation results of program impact and intervention effect. To better support students, schools, school-based healthcare workers, and community, it is important to know about the effectiveness of school-based programs; yet in the last decade, there has been no national appraisal of these programs in Australia. This systematic review aims to report on the effectiveness of Australian school-based wellbeing programs through a search of 13 databases. Out of 2888 articles, 29 met inclusion criteria. The results found that seventeen interventions comprising 80% of the total number of participants reported no statistically significant intervention effect on wellbeing outcomes. We argue that supporting wellbeing through robust program intervention is important as wellbeing presents both an indication of later onset of more serious mental health issues, and an opportunity for early intervention to break the trajectory leading to full disorder.
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Affiliation(s)
- Harshi Gunawardena
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia;
| | | | - Sham Nair
- Curriculum and Reform Directorate, NSW Department of Education, Sydney 2001, Australia;
| | - Shane Cross
- Orygen, Parkville 3052, Australia;
- School of Psychology, Faculty of Science, The University of Sydney, Camperdown 2006, Australia
| | - Ian B. Hickie
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia;
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Fridell A, Coco C, Borg A, Bölte S. School-based social skills group training (SKOLKONTAKT™): a pilot randomized controlled trial. Front Psychol 2023; 14:1128288. [PMID: 37575413 PMCID: PMC10412818 DOI: 10.3389/fpsyg.2023.1128288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
Purpose Differences in socio-communicative behaviors contribute to social challenges for autistic learners at school and, in turn, are associated with increased risks of educational underachievement, social exclusion, and mental health issues. Given that intervention delivery in natural contexts may enhance skills generalization, build support capacities in society, and have practical advantages for youth and families, SKOLKONTAKT™ has been adapted from the clinically based social skills group training KONTAKT™ for mainstream educational settings to mitigate these risks. Methods A pilot, randomized controlled trial with active controls was conducted in a mainstream Swedish high school. Autistic learners and students with social skills challenges (N = 33; MAGE = 17.5) were randomized to SKOLKONTAKT™ (n = 17) or active control (n = 16). Efficacy was measured at post and follow-up (3 months) on social skills [Social Skills Group Assessment Questionnaire (SSGQ); primary outcome] by parent-, self-, and (masked) teacher-report as well as self-reported life quality and social goal attainment. Results Despite COVID-19 challenges, 70.6% (n = 12) completed SKOLKONTAKT™, and 87.5% (n = 14) completed control groups. SKOLKONTAKT™ improved on a series of items on SSGQ as well as subjective life quality beyond controls. A larger proportion of social goals were attained, and side-effects were of little impact and proportionally fewer in SKOLKONTAKT™. Conclusion SKOLKONTAKT™ is a safe, feasible, and promising intervention option for autistic learners in mainstream educational settings. A larger-scale study is desirable to confirm the effects identified in this pilot study.
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Affiliation(s)
- Anna Fridell
- 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, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Christina Coco
- 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, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Anna Borg
- 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, Stockholm, Sweden
| | - Sven Bölte
- 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, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA, Australia
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Lodewyk K, Bagnell A, Courtney DB, Newton AS. Review: Adverse event monitoring and reporting in studies of pediatric psychosocial interventions: a systematic review. Child Adolesc Ment Health 2023. [PMID: 37463769 DOI: 10.1111/camh.12661] [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] [Accepted: 05/31/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Adverse event monitoring in studies of psychotherapy is crucial to clinical decision-making, particularly for weighing of benefits and harms of treatment approaches. In this systematic review, we identified how adverse events are defined, measured, and reported in studies of psychosocial interventions for children with mental disorders. METHOD Medline, PsycINFO, Embase, ProQuest Dissertations and Theses Global, and the Cochrane Library were searched from January 2011-January 2023, and Google Scholar from January 2011-February 2023. English language experimental and quasi-experimental studies that evaluated the efficacy or effectiveness of psychosocial interventions for childhood mental disorders were included. Information on the definition, assessment, and report of adverse events was extracted using a checklist based on Good Clinical Practice guidelines. RESULTS In this review, 117 studies were included. Studies most commonly involved treating anxiety disorders or obsessive-compulsive disorder (32/117; 27%); 44% of the experimental interventions tested (52/117) were cognitive behavioral therapies. Adverse events were monitored in 36 studies (36/117; 31%) with a protocol used in 19 of these studies to guide monitoring (19/36; 53%). Twenty-seven different events were monitored across the studies with hospitalization the most frequently monitored (3/36; 8%). Event severity was fully assessed in 6 studies (17%) and partially assessed in 12 studies (33%). Only 4/36 studies (11%) included assessing events for cause. CONCLUSIONS To date, adverse events have been inconsistently defined, measured and reported in psychosocial intervention studies of childhood mental health disorders. Information on adverse events is an essential knowledge component for understanding the potential impacts and risks of therapeutic interventions.
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Affiliation(s)
| | | | - Darren B Courtney
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Wichers RH, van der Wouw LC, Brouwer ME, Lok A, Bockting CLH. Psychotherapy for co-occurring symptoms of depression, anxiety and obsessive-compulsive disorder in children and adults with autism spectrum disorder: a systematic review and meta-analysis. Psychol Med 2023; 53:17-33. [PMID: 36404645 DOI: 10.1017/s0033291722003415] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Individuals with autism spectrum disorder (ASD) struggle accessing psychotherapy services for comorbidities, including anxiety-, depressive- and obsessive-compulsive disorders (OCD). Apart from cognitive behavioural therapy (CBT) for anxiety in children with ASD, it is unclear whether psychotherapy is effective for these comorbid disorders.We therefore systematically reviewed any form of psychotherapy for co-occurring symptoms of anxiety, depression and OCD in individuals with ASD.Database searches were conducted until February 2022 using EMBASE, PsycINFO and PubMed. Randomised controlled trials (RCT) were included investigating any form of psychotherapy for symptoms of anxiety, depression and OCD in individuals with ASD. Summary data were extracted, and random-effects meta-analyses were conducted.For CBT 26 RCTs (n = 1251), and for social skills training (SST) 11 RCTs (n = 475) met criteria for inclusion. Pooled effect sizes indicated a moderate reduction of anxiety in children (g = -0.70) and a small reduction of depressive symptoms in adults (g = -0.39). For SST overall effect sizes were small for reduction of anxiety in children (g = -0.35) and adults (g = -0.34) and moderate for reduction of depressive symptoms in children (g = -0.50). Risk of bias was high in 18, moderate in 16 and low in 3 RCTs.Our results provide new and age-specific evidence that: (1) CBT is effective for reducing anxiety in children and to a lesser extent for depressive symptoms in adults with ASD; and (2) social skills interventions are effective for reducing anxiety in children and adults and for depressive symptoms in children with ASD.
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Affiliation(s)
- Robert H Wichers
- Amsterdam UMC - Locatie AMC: Amsterdam UMC Locatie AMC, Amsterdam, Netherlands
| | - Lisa C van der Wouw
- Amsterdam UMC - Locatie AMC: Amsterdam UMC Locatie AMC, Amsterdam, Netherlands
| | - Marlies E Brouwer
- Amsterdam UMC - Locatie AMC: Amsterdam UMC Locatie AMC, Amsterdam, Netherlands
| | - Anja Lok
- Amsterdam UMC - Locatie AMC: Amsterdam UMC Locatie AMC, Amsterdam, Netherlands
| | - Claudi L H Bockting
- Amsterdam UMC - Locatie AMC: Amsterdam UMC Locatie AMC, Amsterdam, Netherlands
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Evans K, Whitehouse AJO, D’Arcy E, Hayden-Evans M, Wallace K, Kuzminski R, Thorpe R, Girdler S, Milbourn B, Bölte S, Chamberlain A. Perceived Support Needs of School-Aged Young People on the Autism Spectrum and Their Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15605. [PMID: 36497683 PMCID: PMC9737194 DOI: 10.3390/ijerph192315605] [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: 09/30/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
With increasing demands for health, disability and education services, innovative approaches can help distribute limited resources according to need. Despite an increased focus on support needs within the clinical pathway and policy landscape, the body of research knowledge on this topic is at a relatively early stage. However, there appears to be a sense of unmet support needs and dissatisfaction with the provision of required support following an autism diagnosis amongst caregivers of young people on the spectrum. The primary aim of this study was to explore the perceived support needs of Australian school-aged young people on the spectrum and their caregiver(s). This was achieved using a phenomenographic Support Needs Interview conducted by occupational therapists during home-visits with caregivers of 68 young people on the spectrum (5-17 years). Qualitative data analysis resulted in two hierarchical outcome spaces, one each for young people and their caregivers, indicating interacting levels of support need areas that could be addressed through a combination of suggested supports. These support needs and suggested supports align with almost all chapters within the Body Functions, Activities and Participation and Environmental Factors domains of the International Classification of Functioning, Disability and Health. The overall goals of meeting these complex and interacting support needs were for the young people to optimize their functioning to reach their potential and for caregivers to ensure the sustainability of their caregiving capacity. A series of recommendations for support services, researchers and policy makers have been made to position support needs as central during the assessment, support and evaluation phases.
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Affiliation(s)
- Kiah Evans
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- School of Allied Health, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
| | - Andrew J. O. Whitehouse
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
| | - Emily D’Arcy
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
- School of Psychological Science, University of Western Australia, Perth 6009, Australia
| | - Maya Hayden-Evans
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
- School of Psychological Science, University of Western Australia, Perth 6009, Australia
| | - Kerry Wallace
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
| | - Rebecca Kuzminski
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
| | - Rebecca Thorpe
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
| | - Sonya Girdler
- School of Allied Health, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
- Karolinska Institutet 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, 171 77 Stockholm, Sweden
| | - Benjamin Milbourn
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
| | - Sven Bölte
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
- Karolinska Institutet 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, 171 77 Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, 104 31 Stockholm, Sweden
| | - Angela Chamberlain
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
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