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Lee V, Vashi N, Roudbarani F, Modica PT, Pouyandeh A, Sellitto T, Ibrahim A, Ameis SH, Elkader A, Gray KM, Kerns CM, Lai MC, Lake J, Thomson K, Weiss JA. Utility of a virtual small group cognitive behaviour program for autistic children during the pandemic: evidence from a community-based implementation study. BMC Health Serv Res 2024; 24:685. [PMID: 38816827 PMCID: PMC11140895 DOI: 10.1186/s12913-024-11033-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 04/23/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Autistic children often experience socioemotional difficulties relating to emotion regulation and mental health problems. Supports for autistic children involve the use of adapted interventions that target emotion regulation and social skills, alongside mental health symptoms. The Secret Agent Society Small Group (SAS: SG), an adapted cognitive behavioural program, has demonstrated efficacy through lab-delivered randomized control trials. However, research is still needed on its effectiveness when delivered by publicly funded, community-based autism providers under real-world ecologically valid conditions, especially within the context of a pandemic. The COVID-19 pandemic has disrupted access to community-based supports and services for autistic children, and programs have adapted their services to online platforms. However, questions remain about the feasibility and clinical utility of evidence-based interventions and services delivered virtually in community-based settings. METHODS The 9-week SAS: SG program was delivered virtually by seven community-based autism service providers during 2020-2021. The program included the use of computer-based games, role-playing tasks, and home missions. Caregivers completed surveys at three timepoints: pre-, post-intervention, and after a 3-month follow-up session. Surveys assessed caregivers' perception of the program's acceptability and level of satisfaction, as well as their child's social and emotional regulation skills and related mental health challenges. RESULTS A total of 77 caregivers (94% gender identity females; Mean = 42.1 years, SD = 6.5 years) and their children (79% gender identity males; Mean = 9.9 years, SD = 1.3 years) completed the SAS: SG program. Caregivers agreed that the program was acceptable (95%) and were highly satisfied (90%). Caregivers reported significant reduction in their child's emotion reactivity from pre- to post-intervention (-1.78 (95% CI, -3.20 to -0.29), p = 0.01, d = 0.36), that continued to decrease after the 3-month booster session (-1.75 (95% CI, -3.34 to -0.16), p = 0.02, d = 0.33). Similarly, improvements in anxiety symptoms were observed (3.05 (95% CI, 0.72 to 5.36), p = 0.006, d = 0.39). CONCLUSIONS As online delivery of interventions for autistic children remains popular past the pandemic, our findings shed light on future considerations for community-based services, including therapists and agency leaders, on how best to tailor and optimally deliver virtually based programming. TRIAL REGISTRATION This study has been registered with ISRCTN Registry (ISRCTN98068608) on 15/09/2023. The study was retroactively registered.
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Affiliation(s)
- Vivian Lee
- Department of Psychology, Carleton University, 214E Social Science Research Building, Ottawa, ON, K1S 5B6, Canada.
| | - Nisha Vashi
- Department of Psychology, York University, 230 BSB, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Flora Roudbarani
- Department of Psychology, York University, 230 BSB, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Paula Tablon Modica
- Department of Psychology, York University, 230 BSB, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Ava Pouyandeh
- Department of Psychology, York University, 230 BSB, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Teresa Sellitto
- Department of Psychology, York University, 230 BSB, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Alaa Ibrahim
- Department of Psychology, York University, 230 BSB, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Stephanie H Ameis
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, 8th Floor, Toronto, ON, M5T 1R8, Canada
| | - Alex Elkader
- Kinark Child and Family Services, 7271 Warden Ave, Markham, ON, L3R 5X5, Canada
| | - Kylie M Gray
- Centre for Education Development, Appraisal, and Research, University of Warwick, Coventry, CV4 7AL, UK
| | - Connor M Kerns
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Meng-Chuan Lai
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, 8th Floor, Toronto, ON, M5T 1R8, Canada
| | - Johanna Lake
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, 8th Floor, Toronto, ON, M5T 1R8, Canada
| | - Kendra Thomson
- Department of Applied Disabilities Studies, Brock University, 1812 Sir Issac Brock Way, St. Catherines, ON, L2S 3A1, Canada
- Azrieli Adult Neurodevelopmental Centre at the Centre for Addiction and Mental Health, 1451 Queen Street West, Toronto, ON, M63 1A1, Canada
| | - Jonathan A Weiss
- Department of Psychology, York University, 230 BSB, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
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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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Lievore R, Cardillo R, Mammarella IC. Let's face it! The role of social anxiety and executive functions in recognizing others' emotions from faces: Evidence from autism and specific learning disorders. Dev Psychopathol 2024:1-13. [PMID: 38327107 DOI: 10.1017/s0954579424000038] [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: 02/09/2024]
Abstract
Youth with different developmental disorders might experience challenges when dealing with facial emotion recognition (FER). By comparing FER and related emotional and cognitive factors across developmental disorders, researchers can gain a better understanding of challenges and strengths associated with each condition. The aim of the present study was to investigate how social anxiety and executive functioning might underlie FER in youth with and without autism spectrum disorders (ASD) and specific learning disorders (SLD). The study involved 263 children and adolescents between 8 and 16 years old divided into three groups matched for age, sex, and IQ: 60 (52 M) with ASD without intellectual disability, 63 (44 M) with SLD, and 140 (105 M) non-diagnosed. Participants completed an FER test, three executive functions' tasks (inhibition, updating, and set-shifting), and parents filled in a questionnaire reporting their children's social anxiety. Our results suggest that better FER was consistent with higher social anxiety and better updating skills in ASD, while with lower social anxiety in SLD. Clinical practice should focus on coping strategies in autistic youth who could feel anxiety when facing social cues, and on self-efficacy and social worries in SLD. Executive functioning should also be addressed to support social learning in autism.
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Affiliation(s)
- Rachele Lievore
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Ramona Cardillo
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Irene C Mammarella
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
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Scarcella I, Marino F, Failla C, Doria G, Chilà P, Minutoli R, Vetrano N, Vagni D, Pignolo L, Di Cara M, Settimo C, Quartarone A, Cerasa A, Pioggia G. Information and communication technologies-based interventions for children with autism spectrum conditions: a systematic review of randomized control trials from a positive technology perspective. Front Psychiatry 2023; 14:1212522. [PMID: 37547218 PMCID: PMC10398379 DOI: 10.3389/fpsyt.2023.1212522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/07/2023] [Indexed: 08/08/2023] Open
Abstract
Information and communication technologies (ICTs) have become more widely used in the past years to help people with autism spectrum conditions (ASC). Serious games embedded into computers or tablets, as well as social robots, are the most employed ICT-related tools that are appealing to and appropriate for autistic children. The goal of ICT applications is to enhance behavioral abnormalities associated with ASC while also creating an interactive link between one person and one computer. Comparatively, to human-based therapy, ICT tools aid to inspire autistic children by providing predictability and regularity of tasks. Regaining social skills is the primary behavioral goal for which ICT tools have been designed and implemented. In the past several years, many studies have been created to show how effective it is at improving targeted behaviors. However, only a small number of researchers have used an RCT approach to evaluate its effectiveness. In this systematic review, we only included RCT studies where ICT technologies were used to help children with ASC in improving their social skills. Only 14 RCT studies satisfied the criteria and 12 described significant improvements, showing how the use of technology in educational contexts produced better improvement in developing several social skill facets with respect to the traditional face-to-face approach. Some studies used interventions and outcome measures focused on the core ASC symptoms, but many others addressed neurocognitive functions directly, like social cognition or emotional regulation, while other more general functions such as language or adaptive behaviors. We propose a classification based on processes and outcome measures to foster future research in this specific area of research. The behavioral intervention mediated by technological tools such as computer-based, tablet, and social robotics, undoubtedly provides a comfortable environment that promotes constant learning for people with ASC. Evidence provided in this review highlights the translational potential of this field of study in primary care practice and educational settings.
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Affiliation(s)
- Ileana Scarcella
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - Flavia Marino
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Chiara Failla
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Kore University of Enna, Enna, Italy
| | - Germana Doria
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - Paola Chilà
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - Roberta Minutoli
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - Noemi Vetrano
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Department of Cognitive, Psychological Science and Cultural Studies, University of Messina, Messina, Italy
| | - David Vagni
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | | | | | | | | | - Antonio Cerasa
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- S'Anna Institute, Crotone, Italy
- Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
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Abstract
Relative to males, women with autism spectrum disorder (ASD) have neurobiological and clinical presentation differences. Recent research suggests that the male/female ASD prevalence gap is smaller than previously reported. Sex differences in symptom presentation as well as the male bias of ASD account for delayed/missed diagnosis among women. Investigating ASD and providing psychological evaluation referrals for women who are struggling socially and present with complex mental health conditions (e.g., ADHD, depression), even when they do not show typical autistic characteristics, is important. Accurate diagnosis facilitates understanding of challenges, increases access to treatments, and alleviates the burden of ASD.
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Affiliation(s)
- Cesar Ochoa-Lubinoff
- Rush University Medical Center, 1725 West Harrison Street, Suite 710, Chicago, IL 60612, USA.
| | - Bridget A Makol
- Rush University Medical Center, 1653 West Congress Parkway, 12 Kellogg, Chicago, IL 60612, USA
| | - Emily F Dillon
- Rush University Medical Center, 1645 West Jackson Boulevard, Chicago, IL 60612, USA
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Sánchez-Cueva MS, Alcantud Marín F, Alonso-Esteban Y. Ansiedad y trastornos del espectro del autismo: notas para la intervención psicoeducativa. SIGLO CERO REVISTA ESPAÑOLA SOBRE DISCAPACIDAD INTELECTUAL 2022. [DOI: 10.14201/scero2022534930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Se analizan de forma narrativa las relaciones entre comportamiento sensorial atípico, intolerancia a la incertidumbre y regulación emocional como generadores de los trastornos de ansiedad en niños y niñas autistas. El objetivo es estudiar el origen de la ansiedad en los niños y niñas autistas con la finalidad de determinar cuál o cuáles pueden ser los procedimientos de intervención más adecuados. Se han revisado algunos de los programas de intervención cognitivo-conductuales más utilizados en niños y niñas autistas y las adaptaciones realizadas a los mismos. Se observa un divorcio entre los programas psicoeducativos escolares y los programas clínicos de intervención para el tratamiento de la ansiedad. Como conclusión, se recomienda que en los programas psicoeducativos escolares se incorporen acciones proactivas en forma de programas de intervención cognitivo-conductuales para evitar o aminorar los efectos negativos de la ansiedad en el aprendizaje e inclusión escolar de los niños y las niñas autistas.
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Clifford P, Gevers C, Jonkman KM, Boer F, Begeer S. The effectiveness of an attention-based intervention for school-aged autistic children with anger regulating problems: A randomized controlled trial. Autism Res 2022; 15:1971-1984. [PMID: 36053934 PMCID: PMC9804490 DOI: 10.1002/aur.2800] [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: 02/17/2022] [Accepted: 08/11/2022] [Indexed: 01/05/2023]
Abstract
Anger regulation is a challenge for children with autism spectrum disorders (ASD). We investigated if attention-based cognitive behavioral treatment, based on mindfulness cognitive therapy (MBCT) and dialectical behavior therapy (DBT), reduces aggressive behavior and improves anger coping in school-aged autistic children (n = 51). Children were randomized to an active-control or a treatment condition. The treatment included nine weekly sessions attention-based individual therapy. Parents in both conditions received three weekly psychoeducation group sessions to heighten awareness of expressed emotion (EE). For aggressive behavior, treatment reduced temper tantrums and arguing. No effect was found on destroying things and physical violence. For anger coping, treatment increased adaptive coping strategies of diffusion and social support seeking, but had no effect on assertion, rumination, and maladaptive coping direct anger out and avoidance. Treatment did not impact secondary outcome measures concerning children's quality of life (QoL) and parental stress-levels and psychological well-being. In conclusion, school-aged autistic children are able to acquire self-regulation skills reducing temper tantrums and arguing and increasing the use of adaptive anger coping strategies. The intervention shows potential to improve behavior and regulation, but little transfer to other domains. Limitations and future directions involving the child's social environment, including parents, siblings, and teachers are discussed. LAY SUMMARY: Children on the autism spectrum often show aggressive behavior. Treatment can train children to be more aware of their emotions. This study found that this can help reducing temper tantrums and arguing and increasing some coping skills, though no impact was found on several other domains of aggression and coping.
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Affiliation(s)
| | | | - Kim M. Jonkman
- Department of Clinical‐Neuro and Developmental PsychologyVrije Universiteit AmsterdamAmsterdamBTThe Netherlands
- Amsterdam Public HealthVrije Universiteit AmsterdamAmsterdamBTThe Netherlands
| | - Frits Boer
- Child and Adolescent PsychiatryAmsterdam Medical CenterAmsterdamAZThe Netherlands
| | - Sander Begeer
- Department of Clinical‐Neuro and Developmental PsychologyVrije Universiteit AmsterdamAmsterdamBTThe Netherlands
- Amsterdam Public HealthVrije Universiteit AmsterdamAmsterdamBTThe Netherlands
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Rosen TE, Pickard K, Ponomaryova A, Kerns CM, Reaven J. From Clinic to Classroom: Two Case Studies of Youth With ASD and Anxiety From the School-Based Facing Your Fears Program. J Cogn Psychother 2022; 36:24-41. [PMID: 35121677 DOI: 10.1891/jcpsy-d-20-00051] [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: 11/25/2022]
Abstract
Cognitive behavioral therapy (CBT) is considered best practice for treating anxiety in youth with autism spectrum disorder (ASD) in clinic settings. However, there is significant need to translate CBT into school settings. This paper presents two case illustrations of students who participated in the Facing Your Fears: School-Based program (FYF-SB), a manualized, group CBT intervention for anxiety in ASD, adapted for delivery in schools by interdisciplinary school providers. Students showed improvement in anxiety across multiple domains following intervention, according to clinical interview and parent- and self-report. These outcomes suggest that anxious youth with ASD can benefit from CBT delivered by interdisciplinary school providers. Importantly, decreases in anxiety symptoms were evident in domains that were not explicitly targeted during intervention. Overall, these case illustrations help frame areas of future research, including examining how treatment gains may generalize across anxiety domains as well as whether corresponding improvement in school functioning occurs.
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Affiliation(s)
- Tamara E Rosen
- JFK Partners, Department of Psychiatry and Pediatrics, University of Colorado, Aurora, Colorado, USA
| | - Katherine Pickard
- Marcus Autism Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Anastasiya Ponomaryova
- Department of Psychiatry and Behavioral Sciences, Montefiore Hospital/Albert Einstein College of Medicine, Bronx, New York, USA
| | - Connor M Kerns
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Judy Reaven
- JFK Partners, Department of Psychiatry and Pediatrics, University of Colorado, Aurora, Colorado, USA
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Gosling CJ, Cartigny A, Mellier BC, Solanes A, Radua J, Delorme R. Efficacy of psychosocial interventions for Autism spectrum disorder: an umbrella review. Mol Psychiatry 2022; 27:3647-3656. [PMID: 35790873 PMCID: PMC9708596 DOI: 10.1038/s41380-022-01670-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/31/2022] [Accepted: 06/09/2022] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The wide range of psychosocial interventions designed to assist people with Autism Spectrum Disorder (ASD) makes it challenging to compile and hierarchize the scientific evidence that supports the efficacy of these interventions. Thus, we performed an umbrella review of published meta-analyses of controlled clinical trials that investigated the efficacy of psychosocial interventions on both core and related ASD symptoms. METHODS Each meta-analysis that was identified was re-estimated using a random-effects model with a restricted maximum likelihood estimator. The methodological quality of included meta-analyses was critically appraised and the credibility of the evidence was assessed algorithmically according to criteria adapted for the purpose of this study. RESULTS We identified a total of 128 meta-analyses derived from 44 reports. More than half of the non-overlapping meta-analyses were nominally statistically significant and/or displayed a moderate-to-large pooled effect size that favored the psychosocial interventions. The assessment of the credibility of evidence pointed out that the efficacy of early intensive behavioral interventions, developmental interventions, naturalistic developmental behavioral interventions, and parent-mediated interventions was supported by suggestive evidence on at least one outcome in preschool children. Possible outcomes included social communication deficits, global cognitive abilities, and adaptive behaviors. Results also revealed highly suggestive indications that parent-mediated interventions improved disruptive behaviors in early school-aged children. The efficacy of social skills groups was supported by suggestive evidence for improving social communication deficits and overall ASD symptoms in school-aged children and adolescents. Only four meta-analyses had a statistically significant pooled effect size in a sensitivity analysis restricted to randomized controlled trials at low risk of detection bias. DISCUSSION This umbrella review confirmed that several psychosocial interventions show promise for improving symptoms related to ASD at different stages of life. However, additional well-designed randomized controlled trials are still required to produce a clearer picture of the efficacy of these interventions. To facilitate the dissemination of scientific knowledge about psychosocial interventions for individuals with ASD, we built an open-access and interactive website that shares the information collected and the results generated during this umbrella review. PRE-REGISTRATION PROSPERO ID CRD42020212630.
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Affiliation(s)
- Corentin J. Gosling
- Paris Nanterre University, DysCo Laboratory, F-92000 Nanterre, France ,grid.508487.60000 0004 7885 7602Université de Paris, Laboratoire de Psychopathologie et Processus de Santé, F-92100 Boulogne-Billancourt, France ,grid.5491.90000 0004 1936 9297Centre for Innovation in Mental Health (CIMH), School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Ariane Cartigny
- grid.508487.60000 0004 7885 7602Université de Paris, Laboratoire de Psychopathologie et Processus de Santé, F-92100 Boulogne-Billancourt, France ,grid.413235.20000 0004 1937 0589Department of Child and Adolescent Psychiatry, Robert Debré Hospital, APHP, Paris, France
| | | | - Aleix Solanes
- grid.10403.360000000091771775Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain
| | - Joaquim Radua
- grid.10403.360000000091771775Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain ,grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Richard Delorme
- grid.413235.20000 0004 1937 0589Department of Child and Adolescent Psychiatry, Robert Debré Hospital, APHP, Paris, France ,grid.428999.70000 0001 2353 6535Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
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Duncan A, Liddle M, Stark LJ. Iterative Development of a Daily Living Skills Intervention for Adolescents with Autism Without an Intellectual Disability. Clin Child Fam Psychol Rev 2021; 24:744-764. [PMID: 34196895 PMCID: PMC8247110 DOI: 10.1007/s10567-021-00360-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 01/24/2023]
Abstract
Daily living skill deficits commonly co-occur in individuals with autism spectrum disorder (ASD). These deficits in adolescence are associated with poor outcomes, in both employment and independent living skills as adults. Currently, there are no interventions that directly target daily living skill acquisition in adolescents with ASD without an intellectual disability to facilitate a successful transition to adulthood. In this paper, we discuss the development, refinement, and initial efficacy studies of Surviving and Thriving in the Real World (STRW), a 14-session group treatment for both adolescents with ASD and their parent/caregiver that promotes attainment of critical daily living skills. We summarize initial feasibility studies that have been instrumental in the iterative development of STRW. The structure, core treatment elements, and content of STRW are described in detail. Lastly, we discuss the transition of the in-person STRW intervention to STRW-telehealth, which allows for adolescents with ASD to work on daily living skills in their own home with support from a therapist.
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Affiliation(s)
- Amie Duncan
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039 USA
- University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Melissa Liddle
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039 USA
| | - Lori J. Stark
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039 USA
- University of Cincinnati College of Medicine, Cincinnati, OH USA
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Perihan C, Bicer A, Bocanegra J. Assessment and Treatment of Anxiety in Children with Autism Spectrum Disorder in School Settings: A Systematic Review and Meta-Analysis. SCHOOL MENTAL HEALTH 2021; 14:153-164. [PMID: 34178161 PMCID: PMC8211940 DOI: 10.1007/s12310-021-09461-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2021] [Indexed: 12/28/2022]
Abstract
Anxiety is the most common mental health problem that occurs with Autism Spectrum Disorder (ASD), and due to creating a more inclusive learning environment, children with ASD are placed in general education classrooms. Thus, addressing anxiety problems for children with ASD in school settings become critically important. This systematic review and meta-analysis investigated the current qualities of studies and the effects of school-based interventions for reducing anxiety in children with ASD. The study included six studies with a total of 165 participants. A random-effect meta-analysis yielded a moderate overall effect (g = - 0.58, 95% CI [- 0.96, - 0.20], z = - 3.01, p < .05) with no significant heterogeneity, Q (5) = 7.31, p = 0.20. Findings of the systematic review indicated that school-based interventions for anxiety problems are still in the early stages, and studies showed significant issues with adaptations of current clinical-based interventions and anxiety measurements to use in school settings for children with ASD. Interpretation of these findings and implications are discussed.
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Affiliation(s)
- Celal Perihan
- Department of Teaching and Education Studies, Idaho State University, 62 E Terry St, Room 108C, Pocatello, USA
| | - Ali Bicer
- School of Teacher Education, University of Wyoming, Wyoming Hall, Room 451, Laramie, WY 82071 USA
| | - Joel Bocanegra
- Department of School Psychology and Educational Leadership, Idaho State University, 62 E Terry St, Room 108A, Pocatello, USA
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12
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Lei J, Russell A. I Have a Fear of Negative Evaluation, Get Me Out of Here! Examining Latent Constructs of Social Anxiety and Autistic Traits in Neurotypical and Autistic Young People. J Autism Dev Disord 2021; 51:1729-1747. [PMID: 32808152 PMCID: PMC8084828 DOI: 10.1007/s10803-020-04657-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Understanding shared and unique constructs underlying social communication difficulties in autism spectrum disorder (ASD) and social anxiety disorder (SAD) can address potential diagnostic overshadowing when evaluating SAD in the context of autism. Using self-report measures, factor analyses examined constructs underlying autistic traits, social anxiety, internalising symptoms and wellbeing amongst 267 neurotypical (17-19 years) and 145 autistic (15-22 years) students in the UK. Shared constructs across measures assessed general social communication competency (e.g., social distress in new situations and peer relationships). Fear of Negative Evaluation (FNE) was identified in both samples as a stable construct unique to social anxiety. Adapting interventions targeting SAD in autism should target FNE during adolescence which marks a period of heightened peer interaction and social vulnerability.
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Affiliation(s)
- Jiedi Lei
- Department of Psychology, Centre for Applied Autism Research, University of Bath, Bath, BA2 7AY, UK.
| | - Ailsa Russell
- Department of Psychology, Centre for Applied Autism Research, University of Bath, Bath, BA2 7AY, UK
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13
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Bemmer ER, Boulton KA, Thomas EE, Larke B, Lah S, Hickie IB, Guastella AJ. Modified CBT for social anxiety and social functioning in young adults with autism spectrum disorder. Mol Autism 2021; 12:11. [PMID: 33557903 PMCID: PMC7871647 DOI: 10.1186/s13229-021-00418-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/21/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND There is a strong research imperative to investigate effective treatment options for adolescents and adults with autism spectrum disorder (ASD). Elevated social anxiety, difficulties with social functioning and poor mental health have all been identified as core treatment targets for this group. While theoretical models posit a strong bidirectionality between social anxiety and ASD social functioning deficits, few interventions have targeted both domains concurrently. Of the two group interventions previously conducted with adolescents and adults with ASD, significant results have only been observed in either social anxiety or social functioning, and have not generalised to changes in overall mood. The aim of this study was to evaluate the potential benefit, tolerability and acceptability of a group cognitive-behaviour therapy (CBT) intervention in young adults with ASD. Primary treatment outcomes were social anxiety symptoms and social functioning difficulties; secondary outcomes were self-reported mood and overall distress. METHOD Ten groups of participants completed an eight-week, modified group CBT intervention targeting both social anxiety and social functioning, that included social skills training, exposure tasks and behavioural experiment components. Seventy-eight adolescents and young adults with ASD, without intellectual impairment, aged between 16 and 38 (M = 22.77; SD = 5.31), were recruited from the community, Headspace centres and the Autism Clinic for Translational Research at the Brain and Mind Centre, University of Sydney. Outcomes (social anxiety, social functioning and mood) were measured pre- and post-intervention via self-report questionnaires (administered either online or through the return of hard-copy booklets), and participants were invited to provide anonymous feedback on the intervention (at the mid-point and end of the intervention). RESULTS Participants demonstrated statistically significant improvements on all outcome measures in response to the intervention. Specifically, social anxiety symptoms decreased (p < .001), and specific subdomains of social functioning improved post-intervention, particularly in social motivation (p = .032) and restricted interests and repetitive behaviours (p = .025). Self-reported symptom improvements also generalised to mood (depression, anxiety and stress; p < .05). All improvements demonstrated small effect sizes. Participant feedback was positive and indicated strong satisfaction with the program. LIMITATIONS The absence of a control group and follow-up measures, reliance on self-report instruments as outcome measures and the exclusion of those with intellectual disability represent significant limitations to this study. CONCLUSIONS These findings indicate that a group CBT intervention appears to be a beneficial intervention for self-reported social anxiety, social functioning and overall mental health in adolescents and young adults with ASD. The stand-alone nature of the intervention combined with positive participant feedback indicates it was well tolerated, has potential clinical utility and warrants further study in a randomised-controlled, follow-up design.
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Affiliation(s)
- Emily R. Bemmer
- Autism Clinic for Translational Research, Brain and Mind Centre, Child Neurodevelopment and Mental Health Team, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia
- School of Psychology, University of Sydney, Sydney, 2050 Australia
| | - Kelsie A. Boulton
- Autism Clinic for Translational Research, Brain and Mind Centre, Child Neurodevelopment and Mental Health Team, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050 Australia
| | - Emma E. Thomas
- Autism Clinic for Translational Research, Brain and Mind Centre, Child Neurodevelopment and Mental Health Team, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia
| | - Ben Larke
- Autism Clinic for Translational Research, Brain and Mind Centre, Child Neurodevelopment and Mental Health Team, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia
| | - Suncica Lah
- School of Psychology, University of Sydney, Sydney, 2050 Australia
| | - Ian B. Hickie
- Autism Clinic for Translational Research, Brain and Mind Centre, Child Neurodevelopment and Mental Health Team, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia
| | - Adam J. Guastella
- Autism Clinic for Translational Research, Brain and Mind Centre, Child Neurodevelopment and Mental Health Team, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 100 Mallet Street, Camperdown, NSW 2050 Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050 Australia
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14
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Hooks E, Dale BA, Hernandez Finch ME. Profile analysis of the Personality Assessment Inventory‐Adolescent (PAI‐A) for individuals with autism spectrum disorder. PSYCHOLOGY IN THE SCHOOLS 2020. [DOI: 10.1002/pits.22453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Elizabeth Hooks
- Critical Care Unit for Behavioral Supports Behavioral Dimensions, Inc. Minnesota USA
| | - Brittany A. Dale
- Department of Special Education Ball State University Muncie Indiana USA
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15
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Witchey SK, Al Samara L, Horman BM, Stapleton HM, Patisaul HB. Perinatal exposure to FireMaster® 550 (FM550), brominated or organophosphate flame retardants produces sex and compound specific effects on adult Wistar rat socioemotional behavior. Horm Behav 2020; 126:104853. [PMID: 32949556 PMCID: PMC7726037 DOI: 10.1016/j.yhbeh.2020.104853] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/31/2020] [Accepted: 09/10/2020] [Indexed: 12/11/2022]
Abstract
Firemaster 550 (FM550) is a flame retardant (FR) mixture that has become one of the most commonly used FRs in household items such as foam-based furniture and baby products. Because this mixture readily leaches from products, contamination of the environment and human tissues is widespread. Prior work by us and others has reported sex-specific behavioral deficits in rodents and zebrafish following early life exposure. In an effort to understand the mechanisms by which these behavioral effects occur, here we explored the effects of its constituents on behavioral outcomes previously shown to be altered by developmental FM550 exposure. The FM550 commercial mixture is composed of two brominated compounds (BFR) and two organophosphate compounds (OPFRs) at almost equivalent proportions. Both the BFR and the OPFR components are differentially metabolized and structurally distinct, but similar to known neurotoxicants. Here we examined adult Wistar rat offspring socioemotional behaviors following perinatal exposure (oral, to the dam) to vehicle, 2000 μg/day FM550, 1000 μg/day BFR or 1000 μg/day OPFR from gestation day 0 to weaning. Beginning on postnatal day 65 offspring from all groups were subjected to a series of behavioral tasks including open field, elevated plus maze, marble burying, social interaction tests, and running wheel. Effects were exposure-, sex- and task-specific, with BFR exposure resulting in the most consistent behavioral deficits. Overall, exposed females showed more deficits compared to males across all dose groups and tasks. These findings help elucidate how different classes of flame retardants, independently and as a mixture, contribute to sex-specific behavioral effects of exposure.
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Affiliation(s)
- Shannah K Witchey
- Department of Biological Sciences, NC State University, Raleigh, NC 27695, United States of America; Center for Human Health and the Environment, NC State University, Raleigh, NC 27695, United States of America
| | - Loujain Al Samara
- Department of Biological Sciences, NC State University, Raleigh, NC 27695, United States of America
| | - Brian M Horman
- Department of Biological Sciences, NC State University, Raleigh, NC 27695, United States of America
| | - Heather M Stapleton
- Nicholas School of the Environment, Levine Science Research Center, Duke University, Durham, NC 27710, United States of America
| | - Heather B Patisaul
- Department of Biological Sciences, NC State University, Raleigh, NC 27695, United States of America; Center for Human Health and the Environment, NC State University, Raleigh, NC 27695, United States of America.
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16
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Perihan C, Burke M, Bowman-Perrott L, Bicer A, Gallup J, Thompson J, Sallese M. Effects of Cognitive Behavioral Therapy for Reducing Anxiety in Children with High Functioning ASD: A Systematic Review and Meta-Analysis. J Autism Dev Disord 2020; 50:1958-1972. [PMID: 30810842 DOI: 10.1007/s10803-019-03949-7] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Children with autism spectrum disorder (ASD) are at greater risk for experiencing high levels of anxiety symptoms. Recent evidence suggests Cognitive behavioral therapy (CBT) may also be effective for anxiety reduction in some presentations of ASD. This meta-analysis evaluated twenty-three studies. Results yielded a moderate effect size (g = - 0.66) for the reduction of anxiety symptoms. Moderators indicated larger effects for studies were achieved with parental involvement (g = - 0.85, p < .05) than with child-only treatments (g = - 0.34, p < .05). Short-term interventions generated a smaller effect (g = - 0.37 p < .05) than either standard-term (g = - 1.02, p < .05) or long-term interventions (g = - 0.69, p < .05).Implications for children with ASD are discussed.
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Affiliation(s)
- Celal Perihan
- Department of Teaching and Education Studies, Idaho State University, 62 E Terry St, 83201, Pocatello, ID, USA.
| | - Mack Burke
- Department of Educational Psychology, Texas A&M University, College Station, TX, USA
| | - Lisa Bowman-Perrott
- Department of Educational Psychology, Texas A&M University, College Station, TX, USA
| | - Ali Bicer
- School of Teacher Education, University of Wyoming, Laramie, WY, USA
| | - Jennifer Gallup
- Department of Teaching and Education Studies, Idaho State University, 62 E Terry St, 83201, Pocatello, ID, USA
| | - Julie Thompson
- Department of Educational Psychology, Texas A&M University, College Station, TX, USA
| | - Mary Sallese
- Department of Educational Psychology, Texas A&M University, College Station, TX, USA
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17
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Niego A, Benítez-Burraco A. Autism and Williams syndrome: truly mirror conditions in the socio-cognitive domain? INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 68:399-415. [PMID: 35937179 PMCID: PMC9351567 DOI: 10.1080/20473869.2020.1817717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 06/15/2023]
Abstract
Autism Spectrum Disorders (ASD) and Williams Syndrome (WS) are frequently characterized as mirror conditions in the socio-cognitive domain, with ASD entailing restrictive social interests and with WS exhibiting hypersociability. In this review paper, we examine in detail the strong points and deficits of people with ASD or WS in the socio-cognitive domain and show that both conditions also share some common features. Moreover, we explore the neurobiological basis of the social profile of ASD and WS and found a similar mixture of common affected areas and condition-specific impaired regions. We discuss these findings under the hypothesis of a continuum of the socio-cognitive abilities in humans.
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Affiliation(s)
- Amy Niego
- Faculty of Philology, University of Seville, Seville, Spain
| | - Antonio Benítez-Burraco
- Department of Spanish, Linguistics, and Theory of Literature (Linguistics), Faculty of Philology, University of Seville, Seville, Spain
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18
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Wijnhoven LAMW, Creemers DHM, Vermulst AA, Lindauer RJL, Otten R, Engels RCME, Granic I. Effects of the video game 'Mindlight' on anxiety of children with an autism spectrum disorder: A randomized controlled trial. J Behav Ther Exp Psychiatry 2020; 68:101548. [PMID: 32155470 DOI: 10.1016/j.jbtep.2020.101548] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/09/2020] [Accepted: 01/19/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND OBJECTIVES In the clinical setting, a large proportion of children with an autism spectrum disorder (ASD) experience impairing anxiety symptoms. Recently, an applied videogame called Mindlight has been developed that focuses on decreasing anxiety in children. The present study involved a randomized controlled trial (RCT) investigating the effect of Mindlight on (sub)clinical anxiety symptoms in children with an ASD. METHODS In total, 109 children of 8-16 years old with an ASD and (sub)clinical anxiety symptoms were randomly assigned to the experimental (N = 53) or the control (N = 56) condition. Children in the experimental condition played Mindlight, children in the control condition played a commercial game (Triple Town) for 1 h per week, for six consecutive weeks. All children and parents completed assessments at baseline, post-intervention and 3-months follow-up. RESULTS Results showed no differences in decrease of child-rated anxiety symptoms between both conditions. However, the decrease of parent-rated anxiety symptoms was significantly larger in the experimental condition. LIMITATIONS Mechanisms of change associated with treatment outcomes were not investigated in the present study. Therefore, it remains unclear which specific or non-specific factors contributed to the decrease in anxiety symptoms in both conditions. CONCLUSIONS The present study provided some preliminary evidence that video games are a promising new intervention vehicle for children with an ASD and anxiety, at least according to parents. However, further research on working mechanisms is needed, in order to specify to what extent and for which children with ASD Mindlight could be an effective anxiety treatment.
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Affiliation(s)
- Lieke A M W Wijnhoven
- Mental Health Care Institute GGZ Oost-Brabant, P.O. Box 3, 5427, ZG, Boekel, the Netherlands; Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500, HE, Nijmegen, the Netherlands.
| | - Daan H M Creemers
- Mental Health Care Institute GGZ Oost-Brabant, P.O. Box 3, 5427, ZG, Boekel, the Netherlands; Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500, HE, Nijmegen, the Netherlands.
| | - Ad A Vermulst
- Mental Health Care Institute GGZ Oost-Brabant, P.O. Box 3, 5427, ZG, Boekel, the Netherlands.
| | - Ramón J L Lindauer
- Mental Health Care Institute De Bascule, P.O. Box 303, 1115, ZG, Duivendrecht, the Netherlands; Faculty of Medicine, University of Amsterdam, P.O. Box 22660, 1100, DD, Amsterdam, the Netherlands.
| | - Roy Otten
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500, HE, Nijmegen, the Netherlands; Mental Health Care Institute Pluryn, P.O. Box 53, 6500, AB, Nijmegen, the Netherlands; Arizona State University, REACH Institute, P.O. Box 876005, Tempe, AZ, USA.
| | - Rutger C M E Engels
- Erasmus University, Erasmus School of Social and Behavioral Sciences, P.O. Box 1738, 3000, DR, Rotterdam, the Netherlands.
| | - Isabela Granic
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500, HE, Nijmegen, the Netherlands.
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19
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Tamm L, Zoromski AK, Kneeskern EE, Patel M, Lacey HM, Vaughn AJ, Ciesielski HA, Weadick HK, Duncan AW. Achieving Independence and Mastery in School: An Open Trial in the Outpatient Setting. J Autism Dev Disord 2020; 51:1705-1718. [PMID: 32809169 DOI: 10.1007/s10803-020-04652-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Youth with autism spectrum disorders (ASD) without intellectual disability frequently experience academic problems, in part due to executive functioning (EF) deficits. There are currently no evidence-based interventions targeting academic EF skills (e.g., organization, prioritization, etc.) for middle school youth with ASD. The need is critical given increasing demands on these skills during the transition from elementary to middle school. An intervention targeting academic EF skills, Achieving Independence and Mastery in School (AIMS), was recently developed. This paper reports on an open trial of the AIMS-Outpatient intervention with 21 middle schoolers with ASD. Results suggest high feasibility/satisfaction, and improved EF, particularly in the domains of organization and materials management. These promising results support further intervention development work and suggest that academic EF skills are malleable in youth with ASD.
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Affiliation(s)
- Leanne Tamm
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA.
- University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Allison K Zoromski
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ellen E Kneeskern
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA
| | - Meera Patel
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA
| | - Heather M Lacey
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA
| | - Aaron J Vaughn
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Heather A Ciesielski
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Hannah K Weadick
- University of Cincinnati College of Arts and Sciences, 155 B McMicken Hall, Cincinnati, OH, 45221, USA
| | - Amie W Duncan
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
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20
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Yamada T, Miura Y, Oi M, Akatsuka N, Tanaka K, Tsukidate N, Yamamoto T, Okuno H, Nakanishi M, Taniike M, Mohri I, Laugeson EA. Examining the Treatment Efficacy of PEERS in Japan: Improving Social Skills Among Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2020; 50:976-997. [PMID: 31823217 PMCID: PMC7010628 DOI: 10.1007/s10803-019-04325-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study examines the efficacy of the Japanese version of the Program for the Education and Enrichment of Relational Skills (PEERS), which focuses on improving social functioning through making friends and maintaining good relationships for adolescents with autism spectrum disorder (ASD) without intellectual disabilities. Originally developed in the United States, PEERS is one of the few evidence-based social skills training programs for youth with ASD. The present study shows that with linguistic and cultural modifications, PEERS is effective in improving social functioning for adolescents with ASD in Japan. Positive results were found specifically in the areas of socialization, communication, knowledge of social skills, autistic mannerisms, and behavioral and emotional problems. In addition, most treatment gains were maintained at a 3-month follow-up assessment. These findings suggest that the Japanese version of PEERS is beneficial across multiple socio-emotional and behavioral domains for adolescents with ASD.
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Affiliation(s)
- Tomoko Yamada
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. .,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 13-1-D Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan.
| | - Yui Miura
- Ehime University, 3 Bukyo, Mastuyama, Ehime, 790-8577, Japan
| | - Manabu Oi
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 13-1-D Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Nozomi Akatsuka
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 13-1-D Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Kazumi Tanaka
- Hirakata Board of Education, 1-1-1 Kurumazuka, Hirakata, Osaka, 573-1159, Japan
| | - Naotake Tsukidate
- Yamanashi Eiwa College, 888 Yokone, Kofu, Yamanashi, 400-8555, Japan
| | - Tomoka Yamamoto
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hiroko Okuno
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Mariko Nakanishi
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masako Taniike
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Ikuko Mohri
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Elizabeth A Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Ste.48-243B, Los Angeles, CA, 90024, USA
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21
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Gotham K, Cassidy S, Weiss J. Mental health across the lifespan. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:805-808. [DOI: 10.1177/1362361320912132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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22
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Espelöer J, Hellmich M, Vogeley K, Falter-Wagner CM. Brief Report: Social Anxiety in Autism Spectrum Disorder is Based on Deficits in Social Competence. J Autism Dev Disord 2020; 51:315-322. [PMID: 32410100 PMCID: PMC7810630 DOI: 10.1007/s10803-020-04529-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study differentially examined the relation between two clinical constructs: “social anxiety” and “social competence” in autism spectrum disorder (ASD). Employing two questionnaires (SASKO; IU), individuals with ASD (n = 23) showed increased scores of SOCIAL ANXIETY (SASKO) and of INTOLERANCE OF UNCERTAINTY (IU), compared to a non-clinical comparison group (NC; n = 25). SOCIAL ANXIETY scores were equally increased for ASD and a reference population of individuals with social anxiety disorder (SAD; n = 68). However, results showed increased SOCIAL COMPETENCE DEFICITS in ASD compared to SAD and NC groups. This study allows drawing the conclusion that social anxiety symptoms in ASD can be traced back to autism-specific deficits in social skills and are therefore putatively based on different, substantially “deeper” implemented cognitive mechanisms.
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Affiliation(s)
- J Espelöer
- Department of Psychiatry, University Hospital Cologne, Kerpener Strasse 62, 50924, Cologne, Germany.
| | - M Hellmich
- Faculty of Medicine, Institute of Medical Statistics and Computational Biology, University Hospital Cologne, Kerpener Strasse 62, 50924, Cologne, Germany
| | - K Vogeley
- Department of Psychiatry, University Hospital Cologne, Kerpener Strasse 62, 50924, Cologne, Germany
| | - C M Falter-Wagner
- Department of Psychiatry, Medical Faculty, LMU Munich, Nussbaumstr. 7, 80336, Munich, Germany
- Institute of Medical Psychology, Medical Faculty, LMU Munich, Goethestrasse 31, 80336, Munich, Germany
- Department of Psychology, University of Cologne, Gronewaldstraße 2, 50931, Cologne, Germany
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23
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Ehrenreich-May J, Simpson G, Stewart LM, Kennedy SM, Rowley AN, Beaumont A, Alessandri M, Storch EA, Laugeson EA, Frankel FD, Wood JJ. Treatment of anxiety in older adolescents and young adults with autism spectrum disorders: A pilot study. Bull Menninger Clin 2020; 84:105-136. [PMID: 31967511 DOI: 10.1521/bumc_2020_84_03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Anxiety disorders are commonly comorbid in adolescents and young adults with high-functioning autism. Cognitive-behavioral treatments (CBT) for anxiety, when adapted and expanded to target autism spectrum disorder (ASD) characteristics, may be beneficial, but there is minimal evidence to guide clinicians in their application. This multiple-baseline design study evaluated the initial efficacy of a CBT protocol adapted to address anxiety symptoms and adaptive functioning in this population. Anxiety and ASD symptoms were assessed for six participants at intake, after baseline, posttreatment, and at 1-month follow-up. Parent- and child-reported anxiety was also assessed during baseline and treatment. Visual inspection and reliable change index scores were used to evaluate change. All participants improved on clinician-rated measures of disorder severity, and gains were maintained at follow-up. Results were more equivocal for parent- and self-rated anxiety and parent-rated ASD, partly because of spontaneous changes during baseline.
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Affiliation(s)
- Jill Ehrenreich-May
- Professor, Department of Psychology, University of Miami, Coral Gables, Florida
| | - Gregory Simpson
- Clinical psychologist, University of Guelph, Guelph, Ontario, Canada
| | | | - Sarah M Kennedy
- Assistant professor, University of Colorado School of Medicine, Aurora, Colorado
| | - Amelia N Rowley
- Clinical psychologist, Boston Child Study Center, Boston, Massachusetts
| | - Amy Beaumont
- Director of Social Services, Department of Psychology, University of Miami, Coral Gables, Florida
| | - Michael Alessandri
- Professor, Department of Psychology, University of Miami, Coral Gables, Florida
| | - Eric A Storch
- Senior faculty member, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Elizabeth A Laugeson
- Associate clinical professor, Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California
| | - Frederick D Frankel
- Professor, Department of Psychiatry and Behavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California
| | - Jeffrey J Wood
- Associate professor, Department of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California
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24
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Hronis A, Roberts R, Roberts L, Kneebone I. Potential for children with intellectual disability to engage in cognitive behaviour therapy: the parent perspective. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:62-67. [PMID: 31659831 DOI: 10.1111/jir.12694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/18/2019] [Accepted: 09/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND This study aimed to obtain the opinions of parents and carers of children with intellectual disability (ID) as to whether cognitive behaviour therapy (CBT) could be useful for their children. METHODS A mixed qualitative and quantitative method was employed. Twenty-one carers of children aged 10 to 17 having borderline to moderate intellectual functioning responded to an online questionnaire. Participants were provided with information about CBT and asked to respond to open-ended questions. Quantitative data pertained to questions about their child's ability to identify and describe thoughts, feelings and behaviours. Thematic analysis of responses was conducted using an inductive method of identifying themes from the qualitative data collected. RESULTS Five themes emerged from the qualitative analysis: Emotional Attunement (i.e. parent's understanding and recognition of their child's emotions), Role of the Therapist (i.e. ways therapists could facilitate the intervention), Role of the Parent (i.e. ways parents could engage in the therapy process), Anticipated Obstacles (i.e. what may get in the way of the therapy) and Suggested Adaptations for Therapy (i.e. how CBT can be adapted to suit the needs of children with ID). Seventy-six per cent agreed that their child would be able to engage in CBT with assistance. CONCLUSIONS The majority of parents believed that CBT is an intervention that children with ID could engage in, provided the therapy is adapted, and the therapist accommodates their needs.
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Affiliation(s)
- A Hronis
- Graduate School of Health, University of Technology Sydney, Ultimo, Australia
| | - R Roberts
- The University of Adelaide, Adelaide, Australia
| | - L Roberts
- Graduate School of Health, University of Technology Sydney, Ultimo, Australia
| | - I Kneebone
- Graduate School of Health, University of Technology Sydney, Ultimo, Australia
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25
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Pugliese CE, Ratto AB, Granader Y, Dudley KM, Bowen A, Baker C, Anthony LG. Feasibility and preliminary efficacy of a parent-mediated sexual education curriculum for youth with autism spectrum disorders. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:64-79. [PMID: 31096780 PMCID: PMC6858939 DOI: 10.1177/1362361319842978] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Youth with autism spectrum disorder can face social-communication challenges related to sexuality, dating, and friendships. The purpose of this study was to assess the feasibility, acceptability, and preliminary efficacy of the Supporting Teens with Autism on Relationships program. In total, 84 youth with autism spectrum disorder aged 9 to 18 and their parents participated in this study; two groups received the Supporting Teens with Autism on Relationships program (interventionist-led parent group vs parent self-guided), while an attentional control group received a substance abuse prevention program that included instruction in problem-solving and social skills. Feasibility and acceptability of the Supporting Teens with Autism on Relationships program was high overall. The Supporting Teens with Autism on Relationships program was effective in increasing parent and youth knowledge of sexuality, while the attentional control was not. There was preliminary support for improvement in parenting efficacy related to discussing sexuality with their children. Gains were seen among completers regardless of whether the parent received support from a facilitator. Implications and future directions are discussed.
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26
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de Swart F, Scholte RHJ, Delsing MJMH, van Efferen E, der Stege HV, Nelen W, Burk WJ. Behavioral classroom norms in special education: Associations with peer acceptance and rejection. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2019. [DOI: 10.1177/0165025419885028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated the role of behavioral norms on concurrent links between problem behaviors (externalizing problems, internalizing problems, attention–hyperactivity problems) and social status (acceptance, rejection) in special education classrooms at four time points within and across school years. Two opposing models were considered, the “person–group similarity model,” suggesting moderation of behavioral norms, and the “social skill model,” suggesting no moderation. The sample included a total of 580 pupils (88% boys, Mage Time1 = 10.82 years, SD = .86) attending 37 classrooms from 13 Dutch schools for special education. Multilevel analyses revealed that the data generally supported a “social skill model,” meaning that higher individual levels of attention–hyperactivity problems and externalizing problems were related to lower acceptance and higher rejection, independent of behavioral norms. Support for behavioral norms as moderators of the link between individual behaviors and social status was limited to pupils with attention–hyperactivity problems being less rejected in classrooms in which this behavior was normative. In sum, these results provide an initial exploration of the role of behavioral norms in special education. Various explanations for the results, including special education characteristics and the value of behavioral norms, are discussed.
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Affiliation(s)
| | - Ron H. J. Scholte
- Radboud University, The Netherlands
- Tilburg University, The Netherlands
- Praktikon, The Netherlands
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27
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Ireri NW, White SW, Mbwayo AW. Treating Anxiety and Social Deficits in Children with Autism Spectrum Disorder in Two Schools in Nairobi, Kenya. J Autism Dev Disord 2019; 49:3309-3315. [PMID: 31093801 DOI: 10.1007/s10803-019-04045-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Anxiety in children with Autism Spectrum Disorder (ASD) contributes to their functional impairment. We evaluated a cognitive-behavioral program for anxiety and social deficits in children with ASD in two schools in Nairobi City, Kenya. Parents and teachers of 40 children and adolescents with ASD (5-21 years) participated, randomized by school. The two schools were randomly assigned to either intervention (n = 20) or control (n = 20). There was a significant improvement in ASD severity as well as anxiety within the treatment group, which was not seen in the control group. These findings support the expansion of treatments for ASD core deficits and secondary problems in youth with ASD in developing countries.
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Affiliation(s)
- Niceta W Ireri
- Department of Psychology, School of Education, Africa International University, Nairobi, 18437-00100, Kenya.
| | - Susan W White
- Department of Psychology, University of Alabama, Tuscaloosa, USA
| | - Anne W Mbwayo
- Department of Psychiatry, School of Medicine, University of Nairobi, Nairobi, Kenya
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28
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Discrete electrocortical predictors of anxiety and anxiety-related treatment response in youth with autism spectrum disorder. Biol Psychol 2019; 146:107710. [DOI: 10.1016/j.biopsycho.2019.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 05/30/2019] [Accepted: 05/30/2019] [Indexed: 12/28/2022]
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29
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Hunsche MC, Kerns CM. Update on the effectiveness of psychotherapy for anxiety disorders in children and adolescents with ASD. Bull Menninger Clin 2019; 83:326-352. [DOI: 10.1521/bumc.2019.83.3.326] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A growing body of research has examined the efficacy of varying formats (individual, group, linear, modular) of cognitive-behavioral therapy (CBT) as a treatment for anxiety disorders in children and youth with autism spectrum disorders (ASD). The present review utilized Chambless and Hollon's (1998) criteria for efficacious treatments to: (1) critically review the current evidence base for the efficacy of CBT for anxiety disorders in ASD; and (2) provide recommendations for future research. Findings identify two probably efficacious CBT programs (one group and one individual program) and five possibly efficacious programs, but no well-established programs. Similarities and differences in the components of these programs, which range from unmodified to specifically developed for ASD populations, are highlighted. In addition, the steps required to demonstrate well-established efficacy, and ultimately effectiveness, are discussed alongside other recommendations for refined future research.
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Affiliation(s)
| | - Connor M. Kerns
- University of British Columbia, Vancouver, British Columbia, Canada
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30
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Abstract
Youth with ASD are more likely to experience bullying than their typically developing peers. This risk has not been studied in youth with ASD transitioning to college. We examined the occurrence of bullying in 35 high functioning youth with ASD who were preparing to attend college. We also examined youth anxiety and ASD symptoms. Fifty-one percent of the sample reported being recent victims of bullying; 31% of parents reported their child was a victim of bullying. Parent report of bullying correlated significantly with ratings of youth social anxiety symptoms. These findings suggest that bullying is an issue of concern for higher functioning, older adolescents with ASD, and that their own reports may be particularly important in identifying its occurrence.
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31
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Dyson MW, Chlebowski C, Brookman-Frazee L. Therapists' Adaptations to an Intervention to Reduce Challenging Behaviors in Children with Autism Spectrum Disorder in Publicly Funded Mental Health Services. J Autism Dev Disord 2019; 49:924-934. [PMID: 30368628 DOI: 10.1007/s10803-018-3795-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Publicly funded mental health services play an important role in serving children with autism spectrum disorder (ASD). Previous research indicates a high likelihood of adaptations when therapists deliver evidence based practices to non-ASD populations, though less is known about therapists' use of adaptations for children with ASD receiving mental health services. The current study uses a mixed quantitative and qualitative approach to characterize the types and reasons therapists adapted a clinical intervention [An Individualized Mental Health Intervention for Children with ASD (AIM HI)] for delivery with clinically complex children with ASD served in publicly funded mental health settings and identify therapist characteristics that predict use of adaptations. The most common adaptations were characterized as augmenting AIM HI and were done to individualize the intervention to fit with therapeutic style, increase caregiver participation, and address clients' and caregivers' needs and functioning. No therapist characteristics emerged as significant predictors of adaptations. Results suggest that therapists' adaptations were largely consistent with the AIM HI protocol while individualizing the model to address the complex needs of youth with ASD.
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Affiliation(s)
- Margaret W Dyson
- Department of Psychiatry, University of California, San Diego, CA, USA. .,Child and Adolescent Services Research Center (CASRC), 3020 Children's Way, MC 5033, San Diego, CA, 92123, USA.
| | - Colby Chlebowski
- Department of Psychiatry, University of California, San Diego, CA, USA.,Child and Adolescent Services Research Center (CASRC), 3020 Children's Way, MC 5033, San Diego, CA, 92123, USA
| | - Lauren Brookman-Frazee
- Department of Psychiatry, University of California, San Diego, CA, USA.,Child and Adolescent Services Research Center (CASRC), 3020 Children's Way, MC 5033, San Diego, CA, 92123, USA
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32
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Tan VXL, Simmonds JG. Equine-Assisted Interventions for Psychosocial Functioning in Children and Adolescents with Autism Spectrum Disorder: a Literature Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2018. [DOI: 10.1007/s40489-018-0143-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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33
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Multi-family Psychoeducational Psychotherapy (MF-PEP) for Children with High Functioning Autism Spectrum Disorder. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2018. [DOI: 10.1007/s10879-018-9386-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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34
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Duvekot J, van der Ende J, Verhulst FC, Greaves-Lord K. Examining bidirectional effects between the autism spectrum disorder (ASD) core symptom domains and anxiety in children with ASD. J Child Psychol Psychiatry 2018; 59:277-284. [PMID: 29076153 DOI: 10.1111/jcpp.12829] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Although a bidirectional relationship between autism spectrum disorder (ASD) and anxiety symptoms is assumed, few studies have investigated this. Moreover, little is known about potential differential relationships of the two core symptom domains of ASD - social communication impairment and restricted, repetitive behavior - with anxiety over time. METHOD Participants were 130 children with an ASD (M age 6.7 years, 81.5% boys) of whom 79 participated in a follow-up assessment 2 years later. We used cross-lagged models to test whether social communication impairment and restricted, repetitive behavior at T0 predicted anxiety at T2 and vice versa. RESULTS Crossed-lagged models showed that anxiety symptoms predicted social communication impairment over time (β = .22, p = .008), but not vice versa (β = -.07, p = .49). There were no significant paths from anxiety symptoms to later restricted, repetitive behavior (β = .11, p = .34) or vice versa (β = -.11, p = .27). CONCLUSIONS Our results do not support a bidirectional relationship between the ASD core symptom domains and anxiety, but suggest that higher levels of anxiety symptoms increase the risk of more social communication impairment over time in children with ASD. This underlines the importance of treating anxiety symptoms to improve both social and emotional functioning.
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Affiliation(s)
- Jorieke Duvekot
- Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Jan van der Ende
- Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Frank C Verhulst
- Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Kirstin Greaves-Lord
- Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.,Yulius Mental Health, Dordrecht, The Netherlands
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35
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(±)-MDMA and its enantiomers: potential therapeutic advantages of R(-)-MDMA. Psychopharmacology (Berl) 2018; 235:377-392. [PMID: 29248945 DOI: 10.1007/s00213-017-4812-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 12/06/2017] [Indexed: 10/18/2022]
Abstract
The use of (±)-3,4-methylenedioxymethamphetamine ((±)-MDMA) as an adjunct to psychotherapy in the treatment of psychiatric and behavioral disorders dates back over 50 years. Only in recent years have controlled and peer-reviewed preclinical and clinical studies lent support to (±)-MDMA's hypothesized clinical utility. However, the clinical utility of (±)-MDMA is potentially mitigated by a range of demonstrated adverse effects. One potential solution could lie in the individual S(+) and R(-) enantiomers that comprise (±)-MDMA. Individual enantiomers of racemic compounds have been employed in psychiatry to improve a drug's therapeutic index. Although no research has explored the individual effects of either S(+)-MDMA or R(-)-MDMA in humans in a controlled manner, preclinical research has examined similarities and differences between the two molecules and the racemic compound. This review addresses information related to the pharmacodynamics, neurotoxicity, physiological effects, and behavioral effects of S(+)-MDMA and R(-)-MDMA that might guide preclinical and clinical research. The current preclinical evidence suggests that R(-)-MDMA may provide an improved therapeutic index, maintaining the therapeutic effects of (±)-MDMA with a reduced side effect profile, and that future investigations should investigate the therapeutic potential of R(-)-MDMA.
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36
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Iniesta-Sepúlveda M, Nadeau JM, Ramos A, Kay B, Riemann BC, Storch EA. An Initial Case Series of Intensive Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder in Adolescents with Autism Spectrum Disorder. Child Psychiatry Hum Dev 2018; 49:9-19. [PMID: 28389841 DOI: 10.1007/s10578-017-0724-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Obsessive-compulsive disorder (OCD) is prevalent among youth with autism spectrum disorder (ASD). Cognitive-behavioral therapy (CBT) with ASD-specific modifications has support for treating OCD in this population; however, use of intensive CBT in youth with ASD and severe OCD has not been tested. The current study examined the preliminary effectiveness of an individualized intensive CBT protocol for OCD in adolescents with ASD. Nine adolescents (aged 11-17 years) completed a regimen of intensive CBT (range 24-80 daily sessions) incorporating exposure with response prevention (ERP). Treatment materials, language and techniques were modified in accordance with evidence-based findings for this population. Seven of nine participants (78%) were treatment responders, and large treatment effects (d = 1.35-2.58) were obtained on primary outcomes (e.g., obsessive-compulsive symptom severity). Preliminary findings suggest that an intensive CBT approach for OCD is effective among adolescents with ASD.
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Affiliation(s)
- Marina Iniesta-Sepúlveda
- Department of Psychology, Catholic University of Murcia, Murcia, Spain. .,Department of Education, Catholic University of Murcia, 35 Campus de los Jerónimos, 30107, Guadalupe, Spain.
| | - Joshua M Nadeau
- Department of Pediatrics, University of South Florida, St. Petersburg, FL, USA.,Rogers Memorial Hospital, Oconomowoc, WI, USA
| | - Amaya Ramos
- Rogers Memorial Hospital, Oconomowoc, WI, USA
| | - Brian Kay
- Rogers Memorial Hospital, Oconomowoc, WI, USA
| | | | - Eric A Storch
- Department of Pediatrics, University of South Florida, St. Petersburg, FL, USA.,Rogers Memorial Hospital, Oconomowoc, WI, USA.,Department of Health Policy and Management, University of South Florida, Tampa, FL, USA.,Department of Psychiatry and Behavioral Neurosciences, University of South Florida, St. Petersburg, FL, USA.,Department of Psychology, University of South Florida, St. Petersburg, FL, USA.,All Children's Hospital - Johns Hopkins Medicine, St. Petersburg, FL, USA
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37
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Kose LK, Fox L, Storch EA. Effectiveness of Cognitive Behavioral Therapy for Individuals with Autism Spectrum Disorders and Comorbid Obsessive-Compulsive Disorder: A Review of the Research. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2018; 30:69-87. [PMID: 29568212 PMCID: PMC5858576 DOI: 10.1007/s10882-017-9559-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Autism spectrum disorders (ASD) and obsessive-compulsive disorder (OCD) are highly comorbid, precipitating an urgent need to identify evidence-based practices that might be used to address this comorbidity exclusively. The aim of this study was to conduct a review of intervention research and clinical reports to examine the use of cognitive behavioral therapy (CBT) with individuals who have comorbid ASD and OCD. Based on the pre-determined review inclusion criteria, 11 studies were included in the review: three randomized control trials (RCT), one case controlled study, two single subject experimental designs, and five case studies. These studies offer promising data on the use of CBT interventions for individuals with ASD and comorbid OCD as well as for individuals with OCD and comorbid ASD when standard CBT protocol is enhanced with modifications such as parental involvement, increased use of visuals, personalized treatment metaphors, self-monitoring, positive reinforcement, and use of clear language and instructions. Limitations and implications for future research and practice are discussed.
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Affiliation(s)
- Leman Kaniturk Kose
- Department of Child & Family Studies, University of South Florida, 4202 E. Fowler Avenue MHC2312, Tampa, FL 33612, USA
| | - Lise Fox
- Department of Child & Family Studies, University of South Florida, 4202 E. Fowler Avenue MHC2312, Tampa, FL 33612, USA
| | - Eric A Storch
- Department of Pediatrics, University of South Florida, 880 6th Street South, St. Petersburg, FL 33701, USA
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38
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Nicolini C, Fahnestock M. The valproic acid-induced rodent model of autism. Exp Neurol 2018; 299:217-227. [DOI: 10.1016/j.expneurol.2017.04.017] [Citation(s) in RCA: 235] [Impact Index Per Article: 39.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 04/26/2017] [Accepted: 04/28/2017] [Indexed: 01/12/2023]
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39
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Burkhart K, Knox M, Hunter K. Cognitive-Behavioral Therapy in the Treatment of Internalizing Disorders in High-Functioning Youth with Autism Spectrum Disorder. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2017. [DOI: 10.1007/s10879-017-9374-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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40
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Murphy SM, Chowdhury U, White SW, Reynolds L, Donald L, Gahan H, Iqbal Z, Kulkarni M, Scrivener L, Shaker-Naeeni H, Press DA. Cognitive Behaviour Therapy Versus a Counselling Intervention for Anxiety in Young People with High-Functioning Autism Spectrum Disorders: A Pilot Randomised Controlled Trial. J Autism Dev Disord 2017; 47:3446-3457. [PMID: 28770527 PMCID: PMC5633643 DOI: 10.1007/s10803-017-3252-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The use of cognitive-behavioural therapy (CBT) as a treatment for children and adolescents with autism spectrum disorder (ASD) has been explored in a number of trials. Whilst CBT appears superior to no treatment or treatment as usual, few studies have assessed CBT against a control group receiving an alternative therapy. Our randomised controlled trial compared use of CBT against person-centred counselling for anxiety in 36 young people with ASD, ages 12-18. Outcome measures included parent- teacher- and self-reports of anxiety and social disability. Whilst each therapy produced improvements in participants, neither therapy was superior to the other to a significant degree on any measure. This is consistent with findings for adults.
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Affiliation(s)
- Suzanne M Murphy
- Institute for Health Research, University of Bedfordshire, University Square, Luton, Bedfordshire, LU1 3JU, UK.
| | - Uttom Chowdhury
- East London NHS Foundation Trust, Specialist Child and Adolescent Mental Health Services, Beech Close Resource Centre, Beech Road, Dunstable, Bedfordshire, LU6 3SD, UK
| | - Susan W White
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Laura Reynolds
- Faculty of Health Sciences, Southampton University, University Road, Southampton, SO17 1BJ, UK
| | - Louisa Donald
- Institute for Health Research, University of Bedfordshire, University Square, Luton, Bedfordshire, LU1 3JU, UK
| | - Hilary Gahan
- East London NHS Foundation Trust, Specialist Child and Adolescent Mental Health Services, Beech Close Resource Centre, Beech Road, Dunstable, Bedfordshire, LU6 3SD, UK
| | - Zeinab Iqbal
- Huntercombe Hospital, Buxton, Norwich, NR10 5RH, UK
| | - Mahesh Kulkarni
- East London NHS Foundation Trust, Specialist Child and Adolescent Mental Health Services, Beech Close Resource Centre, Beech Road, Dunstable, Bedfordshire, LU6 3SD, UK
| | - Louise Scrivener
- East London NHS Foundation Trust, Specialist Child and Adolescent Mental Health Services, Beech Close Resource Centre, Beech Road, Dunstable, Bedfordshire, LU6 3SD, UK
| | - Hadi Shaker-Naeeni
- East London NHS Foundation Trust, Specialist Child and Adolescent Mental Health Services, Beech Close Resource Centre, Beech Road, Dunstable, Bedfordshire, LU6 3SD, UK
| | - Dee A Press
- East London NHS Foundation Trust, Specialist Child and Adolescent Mental Health Services, Beech Close Resource Centre, Beech Road, Dunstable, Bedfordshire, LU6 3SD, UK
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41
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Liu S, Yu C, Conner BT, Wang S, Lai W, Zhang W. Autistic traits and internet gaming addiction in Chinese children: The mediating effect of emotion regulation and school connectedness. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 68:122-130. [PMID: 28755535 DOI: 10.1016/j.ridd.2017.07.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 05/26/2017] [Accepted: 07/13/2017] [Indexed: 06/07/2023]
Abstract
This report details an 18-month longitudinal study designed to investigate the influence of autistic traits' on internet gaming addiction (IGA) in children. A total of 420 Chinese children (220 boys, Mean age=9.74±0.45) participated in the research. Autistic traits were measured in the 4th grade and emotion regulation, school connectedness and IGA measured in both the 4th and 5th grades. After controlling for age, sex, and sensation seeking, results showed that autistic traits were related to decreased emotion regulation, which in turn was related to lower school connectedness, which was related to increased IGA. The results suggest that improving emotion regulation and school connectedness could reduce the risk of IGA. As a result, these findings may inform intervention and prevention programs targeting children with IGA, especially among those with high levels of autistic traits.
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Affiliation(s)
- Sha Liu
- School of Psychology & Center for Studies of Psychological Application, South China Normal University, Guangzhou, Guangdong, China
| | - Chengfu Yu
- School of Education & Center for Mind and Brain Science, Guangzhou University, Guangzhou, Guangdong, China
| | - Bradley T Conner
- Department of Psychology, Colorado State University, Fort Collins, CO, United States
| | - Suiping Wang
- School of Psychology & Center for Studies of Psychological Application, South China Normal University, Guangzhou, Guangdong, China
| | - Weiping Lai
- School of Psychology & Center for Studies of Psychological Application, South China Normal University, Guangzhou, Guangdong, China
| | - Wei Zhang
- School of Psychology & Center for Studies of Psychological Application, South China Normal University, Guangzhou, Guangdong, China.
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Barrett CE, Hennessey TM, Gordon KM, Ryan SJ, McNair ML, Ressler KJ, Rainnie DG. Developmental disruption of amygdala transcriptome and socioemotional behavior in rats exposed to valproic acid prenatally. Mol Autism 2017; 8:42. [PMID: 28775827 PMCID: PMC5539636 DOI: 10.1186/s13229-017-0160-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/19/2017] [Indexed: 12/12/2022] Open
Abstract
Background The amygdala controls socioemotional behavior and has consistently been implicated in the etiology of autism spectrum disorder (ASD). Precocious amygdala development is commonly reported in ASD youth with the degree of overgrowth positively correlated to the severity of ASD symptoms. Prenatal exposure to VPA leads to an ASD phenotype in both humans and rats and has become a commonly used tool to model the complexity of ASD symptoms in the laboratory. Here, we examined abnormalities in gene expression in the amygdala and socioemotional behavior across development in the valproic acid (VPA) rat model of ASD. Methods Rat dams received oral gavage of VPA (500 mg/kg) or saline daily between E11 and 13. Socioemotional behavior was tracked across development in both sexes. RNA sequencing and proteomics were performed on amygdala samples from male rats across development. Results Effects of VPA on time spent in social proximity and anxiety-like behavior were sex dependent, with social abnormalities presenting in males and heightened anxiety in females. Across time VPA stunted developmental and immune, but enhanced cellular death and disorder, pathways in the amygdala relative to saline controls. At postnatal day 10, gene pathways involved in nervous system and cellular development displayed predicted activations in prenatally exposed VPA amygdala samples. By juvenile age, however, transcriptomic and proteomic pathways displayed reductions in cellular growth and neural development. Alterations in immune pathways, calcium signaling, Rho GTPases, and protein kinase A signaling were also observed. Conclusions As behavioral, developmental, and genomic alterations are similar to those reported in ASD, these results lend support to prenatal exposure to VPA as a useful tool for understanding how developmental insults to molecular pathways in the amygdala give rise to ASD-related syndromes. Electronic supplementary material The online version of this article (doi:10.1186/s13229-017-0160-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Catherine E Barrett
- Silvio O. Conte Center for Oxytocin and Social Cognition, Division of Behavioral Neuroscience and Psychiatric Disorders, Yerkes National Primate Research Center, Emory University, 954 Gatewood Rd, 30329 Atlanta, GA USA.,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 30329 Atlanta, GA USA
| | - Thomas M Hennessey
- Silvio O. Conte Center for Oxytocin and Social Cognition, Division of Behavioral Neuroscience and Psychiatric Disorders, Yerkes National Primate Research Center, Emory University, 954 Gatewood Rd, 30329 Atlanta, GA USA.,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 30329 Atlanta, GA USA
| | - Katelyn M Gordon
- Silvio O. Conte Center for Oxytocin and Social Cognition, Division of Behavioral Neuroscience and Psychiatric Disorders, Yerkes National Primate Research Center, Emory University, 954 Gatewood Rd, 30329 Atlanta, GA USA.,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 30329 Atlanta, GA USA
| | - Steve J Ryan
- Silvio O. Conte Center for Oxytocin and Social Cognition, Division of Behavioral Neuroscience and Psychiatric Disorders, Yerkes National Primate Research Center, Emory University, 954 Gatewood Rd, 30329 Atlanta, GA USA.,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 30329 Atlanta, GA USA
| | - Morgan L McNair
- Silvio O. Conte Center for Oxytocin and Social Cognition, Division of Behavioral Neuroscience and Psychiatric Disorders, Yerkes National Primate Research Center, Emory University, 954 Gatewood Rd, 30329 Atlanta, GA USA.,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 30329 Atlanta, GA USA
| | - Kerry J Ressler
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA 02478 USA
| | - Donald G Rainnie
- Silvio O. Conte Center for Oxytocin and Social Cognition, Division of Behavioral Neuroscience and Psychiatric Disorders, Yerkes National Primate Research Center, Emory University, 954 Gatewood Rd, 30329 Atlanta, GA USA.,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 30329 Atlanta, GA USA
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Warren LR, Rao PA, Paton DC. A Pilot Observational Study of an Acupressure/Acupuncture Intervention in Children with Autism Spectrum Disorder. J Altern Complement Med 2017; 23:844-851. [PMID: 28530441 DOI: 10.1089/acm.2016.0257] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To determine whether children with autism spectrum disorder (ASD) would tolerate an acupressure/acupuncture intervention and whether parents would adhere to a twice-weekly, 8-week intervention protocol. Second, to further understand best measures to use to capture impact of intervention on behavioral and regulatory functions. DESIGN This is an observational pilot study with pre-, mid-, and postintervention measures. SETTINGS/LOCATION The intervention was carried out in a private practice office in a large metropolitan area. SUBJECTS A total of 10 children of ages 3-10 years with ASD and one of their parents participated. INTERVENTIONS A total of 16 biweekly treatment sessions of acupressure and/or acupuncture were carried out by a licensed acupuncturist, and a daily home-based acupressure intervention was carried out by a parent. OUTCOME MEASURES Attendance, tolerance of intervention, parent compliance with home program, and parent compliance in completing daily diary and five standardized measures of behavioral and regulatory functions pre-, mid-, and postintervention were recorded. RESULTS The 10 children in this observational study, collectively, tolerated the intervention and parents adhered to the 16 sessions, biweekly protocol, and home protocol, as well as completing daily diary and five standardized measures at three different time intervals. The five measurements appeared to be sensitive to behavioral and regulatory functions that may improve with this type of intervention. CONCLUSIONS The results of this observational pilot study suggest that acupressure/acupuncture is a feasible intervention for children with ASD that merits rigorous evaluation through a randomized controlled trial.
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Affiliation(s)
- Lana R Warren
- 1 Clinical Programs, Kennedy Krieger Institute , Baltimore, MD
| | - Patricia A Rao
- 2 Center for Autism and Related Disorders, Kennedy Krieger Institute , Baltimore, MD
| | - David C Paton
- 3 Starting Point Acupuncture and Health Services , Catonsville, MD
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Maddox BB, Miyazaki Y, White SW. Long-Term Effects of CBT on Social Impairment in Adolescents with ASD. J Autism Dev Disord 2016; 47:3872-3882. [DOI: 10.1007/s10803-016-2779-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Walters S, Loades M, Russell A. A Systematic Review of Effective Modifications to Cognitive Behavioural Therapy for Young People with Autism Spectrum Disorders. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2016. [DOI: 10.1007/s40489-016-0072-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Leite IS, Castelhano ASS, Cysneiros RM. Effect of diazepam on sociability of rats submitted to neonatal seizures. Data Brief 2016; 7:686-91. [PMID: 27054178 PMCID: PMC4802817 DOI: 10.1016/j.dib.2016.03.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 03/02/2016] [Accepted: 03/05/2016] [Indexed: 11/28/2022] Open
Abstract
Status epilepticus (SE), an acute condition characterized by repetitive or ongoing seizures activity, may produce long-term deleterious consequences. Previous data demonstrated that Wistar rats subjected to neonatal SE displayed autistic behavior, characterized by social play impairment, low preference by novelty, deficit in social discrimination; anxiety related behavior and stereotyped behavior with no changes in locomotor activity (doi: http://dx.doi.org/10.1007/s00702-010-0460-1, doi: http://dx.doi.org/10.3389/fnbeh.2013.00036, doi: http://dx.doi.org/10.1007/s00702-014-1291-2[1], [2], [3]). Taking into account the bi-directional relationship between the state of anxiety and social interaction (doi: http://dx.doi.org/10.1007/s10567-009-0062-3[4]), we evaluated the impact of the state of anxiety on social interaction. Male Wistar rats at postnatal day 9 were subjected to pilocarpine-induced neonatal SE (380 mg/kg, ip) and the controls received 0.9% saline (0.1 ml/10 g). The groups received saline or diazepam (1.0 mg/kg) 45 min prior each behavioral testing that started from 60 days of postnatal life. In the open field, rats subjected to neonatal seizure exhibited less central zone activity as compared to animals treated with diazepam, with no changes in the total locomotor activity. In elevated plus maze, rats subjected to neonatal seizure and treated with diazepam exhibited higher locomotor activity and spent more time on the open arms as compared to untreated animals. In approach phase of sociability paradigm, animals subjected to neonatal seizures similarly to controls, regardless the treatment, spent more time with social stimulus as compared to non social stimulus. In social novelty phase of sociability paradigm, animals subjected to neonatal seizures differently of controls, regardless the treatment, spent similar time with familiar and novel stimulus.
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Affiliation(s)
- Ingrid Stanize Leite
- Developmental Disabilities Graduate Program, Laboratory of Neurobiology, Mackenzie Presbyterian University, Rua da Consolação, 930. Prédio 28, CEP 01302-907 São Paulo, SP, Brazil
| | - Adelissandra S S Castelhano
- Developmental Disabilities Graduate Program, Laboratory of Neurobiology, Mackenzie Presbyterian University, Rua da Consolação, 930. Prédio 28, CEP 01302-907 São Paulo, SP, Brazil
| | - Roberta M Cysneiros
- Developmental Disabilities Graduate Program, Laboratory of Neurobiology, Mackenzie Presbyterian University, Rua da Consolação, 930. Prédio 28, CEP 01302-907 São Paulo, SP, Brazil
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Danforth AL, Struble CM, Yazar-Klosinski B, Grob CS. MDMA-assisted therapy: A new treatment model for social anxiety in autistic adults. Prog Neuropsychopharmacol Biol Psychiatry 2016; 64:237-49. [PMID: 25818246 DOI: 10.1016/j.pnpbp.2015.03.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 03/16/2015] [Accepted: 03/17/2015] [Indexed: 12/19/2022]
Abstract
The first study of 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy for the treatment of social anxiety in autistic adults commenced in the spring of 2014. The search for psychotherapeutic options for autistic individuals is imperative considering the lack of effective conventional treatments for mental health diagnoses that are common in this population. Serious Adverse Events (SAEs) involving the administration of MDMA in clinical trials have been rare and non-life threatening. To date, MDMA has been administered to over 1133 individuals for research purposes without the occurrence of unexpected drug-related SAEs that require expedited reporting per FDA regulations. Now that safety parameters for limited use of MDMA in clinical settings have been established, a case can be made to further develop MDMA-assisted therapeutic interventions that could support autistic adults in increasing social adaptability among the typically developing population. As in the case with classic hallucinogens and other psychedelic drugs, MDMA catalyzes shifts toward openness and introspection that do not require ongoing administration to achieve lasting benefits. This infrequent dosing mitigates adverse event frequency and improves the risk/benefit ratio of MDMA, which may provide a significant advantage over medications that require daily dosing. Consequently, clinicians could employ new treatment models for social anxiety or similar types of distress administering MDMA on one to several occasions within the context of a supportive and integrative psychotherapy protocol.
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Affiliation(s)
- Alicia L Danforth
- Los Angeles Biomedical Research Institute, Torrance, CA, United States.
| | | | - Berra Yazar-Klosinski
- Multidisciplinary Association for Psychedelic Studies, Santa Cruz, CA, United States.
| | - Charles S Grob
- Department of Psychiatry, Harbor-UCLA Medical Center, Los Angeles Biomedical Research Institute, Torrance, CA, United States.
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Higuchi Y, Uchitomi Y, Fujimori M, Koyama T, Kataoka H, Kitamura Y, Sendo T, Inagaki M. Exploring autistic-like traits relating to empathic attitude and psychological distress in hospital pharmacists. Int J Clin Pharm 2015; 37:1258-1266. [PMID: 26441314 DOI: 10.1007/s11096-11015-10204-11092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 09/21/2015] [Indexed: 05/19/2023]
Abstract
BACKGROUND Pharmacists are expected to play a key role in modern cancer care. Research suggests that an empathic approach and attitude in medical staff improves the quality of patient care. An empathic attitude and psychological distress are thought to be associated with autistic-like traits, but little is known about such traits. OBJECTIVE In this study, we aimed to clarify the associations among autistic-like traits, empathic attitude in a medical context, and psychological health in hospital pharmacists. SETTING Eligibility criteria for inclusion were certified pharmacists working at hospitals for patient care who returned their questionnaires. METHOD Eight hundred and twenty-three hospital pharmacists completed a number of self-administered questionnaires anonymously by mail. MAIN OUTCOME MEASURES Scores were obtained on the Autism-Spectrum Quotient, the Jefferson Scale of Empathy, the General Health Questionnaire-12, and subscales of the Interpersonal Reactivity Index (Perspective Taking, IRI-Empathic Concern, IRIPersonal Distress). We performed correlation and mediation analyses to confirm that the empathy and general health questionnaires were associated with autism-spectrum quotient scores, and with each IRI subscale. RESULTS Complete responses were obtained from 379 pharmacists comprising 151 males (39.8 %) with a mean age of 37.7 ± 10.8 years (missing data, n = 13) and a median of 11 years after qualification as a pharmacist. Autism-Spectrum Quotient scores were inversely correlated with empathy (r = -0.22, p < 0.001) and positively correlated with general health scores (r = 0.40, p < 0.001). In the models with mediation, the inverse correlation between autism-spectrum quotient and empathy scores was mediated indirectly by IRI-Perspective Taking and IRI-Empathic Concern, and the positive correlation between autism-spectrum quotient and general health was mediated indirectly by IRI-Personal Distress. There were also direct effects, with significant effects of autism-spectrum quotient on empathy and general health scores. CONCLUSION Our findings suggest that autistic-like traits affect both empathic attitude in a medical context and the psychological health of pharmacists. We recommend that to improve empathy in those with high levels of autistic-like traits, we may need to develop specialized interventions, such as improving communication skills training.
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Affiliation(s)
- Yuji Higuchi
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center, Tsukiji, Chuo-ku, Tokyo, Japan
| | - Maiko Fujimori
- Center for Suicide Prevention, National Institute of Mental Health, National Center for Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Toshihiro Koyama
- Department of Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hitomi Kataoka
- Department of Primary Care and Medical Education, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshihisa Kitamura
- Department of Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toshiaki Sendo
- Department of Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masatoshi Inagaki
- Department of Neuropsychiatry, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
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Abstract
Anxiety disorders are one of the most common psychiatric comorbidities among children and adolescents with autism spectrum disorders (ASD). There has been a recent proliferation of research examining the prevalence, phenomenology, assessment and treatment of anxiety disorders among youth with ASD. While there is currently very limited support for the use of pharmacological agents to treat anxiety among youth with ASD and comorbid anxiety, there has been overwhelming support across numerous modestly sized controlled studies for the efficacy of cognitive behavioral therapy. This review discusses advances in the treatment literature for anxiety in youth with ASD, and discusses the current evidence base for whether standard treatment needs to be adapted for this population.
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Affiliation(s)
- Carly Johnco
- Department of Pediatrics, University of South Florida
| | - Eric A. Storch
- Department of Pediatrics, University of South Florida
- Department of Psychology, University of South Florida
- Department of Psychiatry & Behavioral Neurosciences, University of South Florida
- Department of Health Policy and Management, University of South Florida
- Rogers Behavioral Health – Tampa Bay
- All Children’s Hospital – Johns Hopkins Medicine
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50
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Hare DJ, Gracey C, Wood C. Anxiety in high-functioning autism: A pilot study of experience sampling using a mobile platform. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2015; 20:730-43. [DOI: 10.1177/1362361315604817] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Anxiety and stress are everyday issues for many people with high-functioning autism, and while cognitive-behavioural therapy is the treatment of choice for the management of anxiety, there are challenges in using it with people with high-functioning autism. This study used modified experience sampling techniques to examine everyday anxiety and stress in adults with high-functioning autism and to explore the feasibility of delivering real-time stress management techniques using a mobile platform. High levels of anxiety were found to be characterised by worry, confusing thoughts and being alone but was not associated with internal focus, imagery or rumination. Participants reported improved mood and less worry and anxious thinking in the active phase of the study. These results support previous studies indicating that people with high-functioning autism differ in their experience of anxiety and provided preliminary data on the feasibility of real-time stress management. The limitations of this approach are discussed together with considerations for future work in the area of developing clinical interventions on mobile platforms.
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