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Wright B, Bell KJ, Blackwell JE, Teige C, Mandefield L, Wang HI, Welch C, Scantlebury A, Watson J, McMillan D, Standley E, Attwell L, Carrick H, Taylor A, Taylor O, Hodkinson R, Edwards H, Pearson H, Parrott S, Marshall D, Varley D, Hargate R, Mclaren A, Elizabeth Hewitt C. Impact of Social Stories on social and emotional health of autism spectrum primary school children: the ASSSIST2 RCT with economic evaluation. Health Technol Assess 2024; 28:1-121. [PMID: 39207130 DOI: 10.3310/jbtm8017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
Background Differences in the way autistic children experience the world can contribute to anxiety and stress. Carol Gray's Social Stories™ are a highly personalised intervention to support children by providing social information about specific situations in an individual story. Objectives This randomised controlled trial aimed to establish whether Social Stories are clinically effective and cost-effective in improving social responsiveness and social and emotional health in children on the autism spectrum in schools. Design A multisite pragmatic cluster randomised controlled trial comparing Social Stories with care as usual. Setting Eighty-seven schools (clusters) across Yorkshire and the Humber. Participants Two hundred and forty-nine children were randomised via a bespoke system hosted at York Trials Unit (129 Social Stories and 120 care as usual). Recruitment was completed in May 2021. Participants were children aged 4-11 years with a diagnosis of autism, alongside teachers, interventionists and caregivers. Recruitment was via schools, NHS trusts, support groups and local publicity. Intervention The intervention included training for educational professionals and caregivers covering psychoeducation and implementation of Social Stories. Stories were written around contextualised goals around the child's need for social information. Interventionists read the Social Story™ with the child at least six times over 4 weeks during school. Main outcome measure The primary outcome was the Social Responsiveness Scale-2 completed by teachers at 6 months (the primary end point), which measures social awareness, cognition, communication and behaviour. Data were collected from caregivers and educational professionals at 6 weeks and 6 months through questionnaires. Blinding of participants was not possible. Results At 6 months, the estimated difference in expected teacher-reported Social Responsiveness Scale-2 T-score (the primary end point) was -1.61 (95% confidence interval -4.18 to 0.96, p = 0.220), slightly favouring the intervention group. The estimated differences for the parent-reported secondary outcomes at 6 months were small and generally favoured the control group except the measure of children's quality-adjusted life-year (+ 0.001, 95% confidence interval -0.032 to 0.035) and parental stress (-1.49, 95% confidence interval -5.43 to 2.46, p = 0.460), which favoured the intervention group. Children in the intervention group met their individual goals more frequently than children who received usual care alone (0.97 confidence interval 0.21 to 1.73, p = 0.012). The intervention is likely to save small costs (-£191 per child, 95% confidence interval -767.7 to 337.7) and maintain a similar quality of life compared to usual care. The probability of Social Stories being a preferred option is 75% if the society is willing to pay £20,000 per quality-adjusted life-year gained. Limitations include considerable disruptions during the coronavirus disease 2019 pandemic. Conclusion Social Stories are used in schools and represent a low-cost intervention. There is no clinically evident impact on social responsiveness, anxiety and/or depression, parental stress or general health. Benefits were observed for specific behavioural goals as assessed by the teacher, and Social Stories may serve as a useful tool for facilitating dialogue between children and school staff to address specific behavioural challenges. Usage should be at the school's discretion. Future work Given the uncertainty of the results in light of coronavirus disease 2019, further work to establish the impact of Social Stories is merited. Trial registration This trial is registered as ISRCTN11634810. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 16/111/91) and is published in full in Health Technology Assessment; Vol. 28, No. 39. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
| | | | | | - Catarina Teige
- Leeds and York Partnership NHS Foundation Trust, Yorkshire, UK
| | | | | | | | | | | | | | | | - Leah Attwell
- Leeds and York Partnership NHS Foundation Trust, Yorkshire, UK
| | - Hayley Carrick
- Leeds and York Partnership NHS Foundation Trust, Yorkshire, UK
| | - Amelia Taylor
- Leeds and York Partnership NHS Foundation Trust, Yorkshire, UK
| | | | | | - Hannah Edwards
- Leeds and York Partnership NHS Foundation Trust, Yorkshire, UK
| | - Hannah Pearson
- Leeds and York Partnership NHS Foundation Trust, Yorkshire, UK
| | | | | | | | - Rebecca Hargate
- Leeds and York Partnership NHS Foundation Trust, Yorkshire, UK
| | - Ann Mclaren
- Patient and public involvement representative
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Camilleri LJ, Maras K, Brosnan M. Effective digital support for autism: digital social stories. Front Psychiatry 2024; 14:1272157. [PMID: 38234364 PMCID: PMC10791792 DOI: 10.3389/fpsyt.2023.1272157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/29/2023] [Indexed: 01/19/2024] Open
Abstract
Social Stories™ is one of the most popular interventions for autistic children and has been researched extensively. However, effectiveness data has been gathered mainly through single-participant designs which generate outcomes which can lack generalizability and social validity. Stories Online For Autism (SOFA) is a digital application which supports the development and delivery of Social Stories in a real-world setting and has the potential to contribute toward furthering (1) Social Stories research and (2) research on digital applications for autism by gathering large data sets from multiple participants. Three data sets (N = 856) were gathered through the SOFA app and were analyzed to investigate three key variables: What predicted closeness-to-goal of the Social Stories (as rated by an adult/parent/guardian, n = 568); the child's comprehension of the Social Stories (assessed by story comprehension questions, n = 127); and the child's rating of the enjoyability of the Social Stories (n = 161). A merged data set then investigated correlations between these three key variables. Age range (≤15), gender, autism diagnosis, and the child's level of language understanding were the potential predictors for these three key variables. Regression analysis indicated that parental closeness-to-goal ratings for their children were highest for children who were younger and more verbal. Regression analysis also indicated that older children scored higher in comprehension assessment, and autistic children rated the Social Stories as more enjoyable. Closeness-to-goal, comprehension scores and enjoyment ratings did not significantly correlate with each other. This is the largest study of Social Stories effectiveness, which was enabled through the collection of data through a digital app from multiple participants. The results indicate that digital social stories are particularly effective for younger verbal children. While this was the case for all children, it was particularly true for autistic children and female (and gender-diverse) children. For the first time, the gathering of large digital data sets has highlighted that while digital Social Stories can be effective for autistic males, they can be more effective for autistic females and gender-diverse autistic individuals. Thus, the SOFA app can support the investigation of the factors which influence Social Stories outcomes that are generalizable and with high social validity.
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Affiliation(s)
- Louis John Camilleri
- Centre for Applied Autism Research (CAAR), University of Bath, Bath, United Kingdom
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3
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Como DH, Goodfellow M, Hudak D, Cermak SA. "A scoping review: Social stories supporting behavior change for individuals with Autism". JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS & EARLY INTERVENTION 2023; 17:154-175. [PMID: 39050966 PMCID: PMC11263915 DOI: 10.1080/19411243.2023.2168824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023]
Abstract
Social Stories (also known as social narratives) help individuals participate in and understand social situations. This scoping review identifies and synthesizes social narrative research targeting behavior change in individuals with ASD. Using the following questions as a guide: (a) What is the scope of social narrative interventions used for individuals with ASD, (b) What behavior change outcome measures are evaluated, and (c) What research designs are used; five databases were searched from 2007-to-2018. Fifty-six articles met the criteria. Primary outcomes were sorted into two macro-categories: Reduce Disruptive Behaviors and Increase Desired Behaviors. Most, but not all, studies were found to be effective for various behaviors such as aggressive actions, verbal protests, identifying emotions, executive functioning, following directions, and responding in social situations. Social narratives can be used to promote skills/behaviors in individuals with ASD to enable participation, an important goal in occupational therapy practice. They are an accessible and feasible intervention that can be implemented in various settings for behaviors including activities of daily living, social skills, independence, and self-regulation. Most research reviewed the single subject design, which is a limitation of the research as it makes results difficult to generalize. However, through replication, functional relationships can be determined. Additional research utilizing randomized control trials is recommended.
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Affiliation(s)
- Dominique H Como
- University of Southern California, Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy
| | - Margaret Goodfellow
- University of Southern California, Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy
| | - Delaney Hudak
- University of Southern California, Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy
| | - Sharon A Cermak
- University of Southern California, Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy
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4
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Puglisi A, Caprì T, Pignolo L, Gismondo S, Chilà P, Minutoli R, Marino F, Failla C, Arnao AA, Tartarisco G, Cerasa A, Pioggia G. Social Humanoid Robots for Children with Autism Spectrum Disorders: A Review of Modalities, Indications, and Pitfalls. CHILDREN 2022; 9:children9070953. [PMID: 35883937 PMCID: PMC9316169 DOI: 10.3390/children9070953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022]
Abstract
Robot-assisted therapy (RAT) is a promising area of translational neuroscience for children with autism spectrum disorders (ASDs). It has been widely demonstrated that this kind of advanced technological tool provides a reliable and efficient intervention for promoting social skills and communication in children with ASD. This type of treatment consists of a human-assisted social robot acting as an intervention mediator to increase competence and skills in children with ASD. Several social robots have been validated in the literature; however, an explicit technical comparison among devices has never been performed. For this reason, in this article, we provide an overview of the main commercial humanoid robots employed for ASD children with an emphasis on indications for use, pitfalls to be avoided, and recent advances. We conclude that, in the near future, a new generation of devices with high levels of mobility, availability, safety, and acceptability should be designed for improving the complex triadic interaction among teachers, children, and robots.
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Affiliation(s)
- Alfio Puglisi
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Tindara Caprì
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
- Department of Life and Health Sciences, Link Campus University, Via del Casale di S. Pio V, 44, 00165 Rome, Italy
| | | | - Stefania Gismondo
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Paola Chilà
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Roberta Minutoli
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Flavia Marino
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Chiara Failla
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Antonino Andrea Arnao
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Gennaro Tartarisco
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
| | - Antonio Cerasa
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
- S’Anna Institute, 88900 Crotone, Italy;
- Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, 87036 Arcavacata, Italy
- Correspondence:
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy; (A.P.); (T.C.); (S.G.); (P.C.); (R.M.); (F.M.); (C.F.); (A.A.A.); (G.T.); (G.P.)
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5
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Dijkstra-de Neijs L, Tisseur C, Kluwen LA, van Berckelaer-Onnes IA, Swaab H, Ester WA. Effectivity of Play-Based Interventions in Children with Autism Spectrum Disorder and Their Parents: A Systematic Review. J Autism Dev Disord 2021; 53:1588-1617. [PMID: 34853960 DOI: 10.1007/s10803-021-05357-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2021] [Indexed: 10/19/2022]
Abstract
Evidence of the effectivity of play-based interventions in children with autism spectrum disorder (ASD) was evaluated by PRISMA-based literature study and a Risk of Bias (RoB) assessment. Many of the 32 eligible randomized controlled trials (RCT) reported improved social interaction, communication, daily functioning and play behaviour. They also reported decreased problem behaviour, better parental attunement and parent-child interaction. We assessed 25/32 of the RCTs with high RoB, mainly related to homogeneity of the study population, lack of power, and performance bias. We concluded with due care that the effectivity of play-based interventions differed across RCTs, most reported improvements are found in ASD symptoms, everyday functioning, and parental attunement. In future research, findings should be replicated, taking account of the RoB.
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Affiliation(s)
- Leanne Dijkstra-de Neijs
- Sarr Expert Centre for Autism, Youz Child- and Adolescent Psychiatry, Parnassia Group, Rotterdam, The Netherlands.,Clinical Neurodevelopmental Sciences, Leiden University, Leiden, The Netherlands
| | - Chanel Tisseur
- Sarr Expert Centre for Autism, Youz Child- and Adolescent Psychiatry, Parnassia Group, Rotterdam, The Netherlands
| | - Laura A Kluwen
- Sarr Expert Centre for Autism, Youz Child- and Adolescent Psychiatry, Parnassia Group, Rotterdam, The Netherlands
| | - Ina A van Berckelaer-Onnes
- Sarr Expert Centre for Autism, Youz Child- and Adolescent Psychiatry, Parnassia Group, Rotterdam, The Netherlands.,Clinical Neurodevelopmental Sciences, Leiden University, Leiden, The Netherlands
| | - Hanna Swaab
- Sarr Expert Centre for Autism, Youz Child- and Adolescent Psychiatry, Parnassia Group, Rotterdam, The Netherlands.,Clinical Neurodevelopmental Sciences, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Wietske A Ester
- Sarr Expert Centre for Autism, Youz Child- and Adolescent Psychiatry, Parnassia Group, Rotterdam, The Netherlands. .,Clinical Neurodevelopmental Sciences, Leiden University, Leiden, The Netherlands. .,Curium-LUMC, Child- and Adolescent Psychiatry, Oegstgeest, The Netherlands.
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6
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Tang WYF, Fong KNK, Chung RCK. The Effects of Storytelling With or Without Social Contextual Information Regarding Eye Gaze and Visual Attention in Children with Autistic Spectrum Disorder and Typical Development: A Randomized, Controlled Eye-Tracking Study. J Autism Dev Disord 2021; 52:1257-1267. [PMID: 33909213 DOI: 10.1007/s10803-021-05012-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2021] [Indexed: 11/24/2022]
Abstract
This study examined the effects of storytelling with or without contextual information on children with autism spectrum disorder (ASD) and typical development (TD) using eye-tracker. They were randomized into two groups-the stories included and did not include social contextual information respectively. Training was delivered in groups, with eight sessions across four weeks, 30 min/session. Participants' fixation duration, visit duration, and fixation count on human faces from 20 photos and a video were recorded. Our findings revealed that storytelling with social contextual information enhanced participants' eye gazes on eyes/ faces in static information (photos) for both children with ASD and TD, but the same advantage could not be seen for children with ASD in regard to dynamic information (videos).Clinical Trial Registration Number (URL: http://www.clinicaltrials.gov ): NCT04587557.
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Affiliation(s)
- Wilson Y F Tang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.,SAHK, Hong Kong, Hong Kong
| | - Kenneth N K Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.
| | - Raymond C K Chung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
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Autism Spectrum Disorder and Social Story Research: a Scoping Study of Published, Peer-Reviewed Literature Reviews. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-020-00235-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractSocial Stories (SS) is a widely used intervention for children on the autism spectrum. A search of databases (CINAH EBSCO, A+Eductaion, ERIC, Education Source, PsyINFO, PubMed, Science Direct, Scopus, Web of Science, and ABI Inform Global) identified that, since its development over 25 years ago, the research exploring SS has been reviewed 17 times. These reviews include synthesis of literature; systematic reviews, meta-analyses; comparative reviews; and descriptive reviews. A scoping review of these 17 literature reviews identified 5 major themes: (1) research design of SS studies, (2) effectiveness of SS, (3) factors influencing outcomes of SSs, (4) social validity of SS interventions, and (5) maintenance and generalisation of SS outcomes. Future recommendations related to SS research were also identified.
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A Pilot Randomised Control Trial of Digitally-Mediated Social Stories for Children on the Autism Spectrum. J Autism Dev Disord 2021; 50:4243-4257. [PMID: 32266683 PMCID: PMC7677143 DOI: 10.1007/s10803-020-04490-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Social stories is a widely used intervention for children on the autism spectrum, particularly within an educational context. To date, systematic reviews and meta analyses of the research evaluating social stories has produced mixed results, often due to a lack of methodological rigour and variability in the development and delivery of the social stories. To address the gap in methodological rigour, a pilot Randomised Control Trial (RCT) was conducted, incorporating a social stories intervention group (n = 9 children on the autism spectrum) and an attentional control group who received a poem (n = 6 children on the autism spectrum) using a digital platform to address variability. Digitally-mediated social stories were found to be effective in producing beneficial changes in behaviour outcomes, which were sustained at a six-week follow up.
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Sportsmanship Interventions for Individuals with Autism Spectrum Disorders: a Systematic Literature Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00240-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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10
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Kent C, Cordier R, Joosten A, Wilkes-Gillan S, Bundy A, Speyer R. A Systematic Review and Meta-analysis of Interventions to Improve Play Skills in Children with Autism Spectrum Disorder. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2019. [DOI: 10.1007/s40489-019-00181-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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A Meta-analysis of School-Based Social Interaction Interventions for Adolescents with Autism Spectrum Disorder. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2017. [DOI: 10.1007/s40489-017-0113-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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12
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Matsuda S, Nunez E, Hirokawa M, Yamamoto J, Suzuki K. Facilitating Social Play for Children with PDDs: Effects of Paired Robotic Devices. Front Psychol 2017; 8:1029. [PMID: 28701971 PMCID: PMC5487447 DOI: 10.3389/fpsyg.2017.01029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Accepted: 06/06/2017] [Indexed: 11/13/2022] Open
Abstract
Interacting with toys and other people is fundamental for developing social communication skills. However, children with autism spectrum disorder (ASD) are characterized by having a significant impairment in social interaction, which often leads to deficits in play skills. For this reason, methods of teaching play skills to young children with ASD have been well documented. Although previous studies have examined a variety of instructional strategies for teaching skills, few studies have evaluated the potential of using robotic devices. The purpose of the present study is to examine whether automatic feedback provided by colored lights and vibration via paired robotic devices, COLOLO, facilitates social play behaviors in children with ASD. We also explore how social play relates to social interaction. COLOLO is a system of paired spherical devices covered with soft fabric. All participants in this study were recruited as volunteers through the Department of Psychology at Keio University. The pilot study included three participants diagnosed with Pervasive Developmental Disorders (PDDs; 5- to 6-year-old boys), and compared experimental conditions with and without automatic feedback from the devices (colored lights and vibration). The results indicated that the participants in the condition that included feedback from the devices exhibited increased rates of ball contact and looking at the therapist’s ball, but did not exhibit increased rates of eye contact or positive affect. In the experimental study, a systematic replication of the pilot study was performed with three other participants diagnosed with PDDs (3- to 6-year-old boys), using an A-B-A-B design. Again, the results demonstrated that, in the condition with colored lights and vibration, the children increased ball contact as well as looking at the therapist’s ball. However, the results did not show the effect of automatic feedback consistently for three children. These findings are discussed in terms of the potential of paired robotic devices as a method to facilitate social play for children with ASD.
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Affiliation(s)
- Soichiro Matsuda
- Artificial Intelligence Laboratory, Faculty of Engineering, Information and Systems, University of TsukubaTsukuba, Japan.,Japan Society for the Promotion of ScienceTokyo, Japan
| | - Eleuda Nunez
- Artificial Intelligence Laboratory, Faculty of Engineering, Information and Systems, University of TsukubaTsukuba, Japan
| | - Masakazu Hirokawa
- Artificial Intelligence Laboratory, Faculty of Engineering, Information and Systems, University of TsukubaTsukuba, Japan
| | | | - Kenji Suzuki
- Artificial Intelligence Laboratory, Faculty of Engineering, Information and Systems, University of TsukubaTsukuba, Japan
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Wright B, Marshall D, Adamson J, Ainsworth H, Ali S, Allgar V, Collingridge Moore D, Cook E, Dempster P, Hackney L, McMillan D, Trepél D, Williams C. Social Stories™ to alleviate challenging behaviour and social difficulties exhibited by children with autism spectrum disorder in mainstream schools: design of a manualised training toolkit and feasibility study for a cluster randomised controlled trial with nested qualitative and cost-effectiveness components. Health Technol Assess 2016; 20:1-258. [PMID: 26792796 DOI: 10.3310/hta20060] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND A Social Story™ (Carol Gray) is a child-friendly intervention that is used to give children with autism spectrum disorders (ASDs) social information in situations where they have social difficulties. Limited evidence mainly using single-case designs suggests that they can reduce anxiety and challenging behaviour. OBJECTIVES The objectives were to conduct a systematic review, use this to develop a manualised intervention and run a feasibility trial to inform a fully powered randomised controlled trial (RCT) on their clinical effectiveness and cost-effectiveness in schools. DESIGN This is a three-stage study following the Medical Research Council framework for complex interventions. Specifically, it involved a theoretical phase, a qualitative stage and a feasibility trial stage. SETTING Qualitative interviews and focus groups took place in Child and Adolescent Mental Health Service and primary care settings. The feasibility study took place in 37 local mainstream schools. PARTICIPANTS Fifty children (aged 5-15 years) in mainstream school settings with a diagnosis of ASD were entered into the trial. For each child, an associated teacher and parent was also recruited. INTERVENTIONS The intervention was a goal-setting session followed by a manualised toolkit (including a training session) for creating Social Stories™ for use with school-aged children. The comparator treatment was a goal-setting session followed by an attention control. Both arms received treatment as usual. MAIN OUTCOME MEASURES Outcomes tested as part of the feasibility study included child- and proxy-completed questionnaires for mental health, quality of life and goal-based outcome measures. Adults additionally completed behaviour diaries and the parental stress index. RESULTS The review found that the research into social stories is predominantly based in the USA, carried out in under-12-year-olds and using single-case designs. Most studies either did not follow established Social Story criteria or did not report if they did. The assessment of effectiveness presents a largely positive picture but is limited by methodological issues. There were no adequate RCTs and insufficient information to assess a number of important sources of potential bias in most studies. A manualised intervention was produced using an iterative process between user focus groups and a writing team, and assessed in the feasibility study. All 50 participant groups were recruited within the study time frame. Two outcome measures, the Social Responsiveness Scale-2 and the custom-made goal-based measure, showed high levels of completion rates and appeared to be capturing social and behaviour skills targeted by the use of Social Stories. Detailed recommendations for a full trial are provided. LIMITATIONS Blinding of participants was not feasible. Treatment fidelity was not assessed because of low levels of story return rates. CONCLUSIONS The study showed that a fully powered RCT is feasible with an extended geographical footprint. A large amount of data and information has helped to inform the design of this RCT, which will be the subject of a future research grant application. Future work could focus on developing an appropriate blinded outcome measure for this population. STUDY REGISTRATION This study is registered as PROSPERO CRD42011001440. TRIAL REGISTRATION Current Controlled Trials ISRCTN96286707. FUNDING This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 6. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Barry Wright
- Lime Trees Child and Adolescent Mental Health Service Research Team, York, UK
| | - David Marshall
- Lime Trees Child and Adolescent Mental Health Service Research Team, York, UK
| | - Joy Adamson
- York Clinical Trials Unit, Department of Health Sciences, York, UK
| | - Hannah Ainsworth
- York Clinical Trials Unit, Department of Health Sciences, York, UK
| | - Shehzad Ali
- Department of Health Sciences, University of York, York, UK
| | | | | | - Elizabeth Cook
- York Clinical Trials Unit, Department of Health Sciences, York, UK
| | - Paul Dempster
- Department of Health Sciences, University of York, York, UK
| | - Lisa Hackney
- Lime Trees Child and Adolescent Mental Health Service Research Team, York, UK
| | - Dean McMillan
- Department of Health Sciences, University of York, York, UK
| | - Dominic Trepél
- Department of Health Sciences, University of York, York, UK
| | - Chris Williams
- Lime Trees Child and Adolescent Mental Health Service Research Team, York, UK
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Marshall D, Wright B, Allgar V, Adamson J, Williams C, Ainsworth H, Cook L, Varley D, Hackney L, Dempster P, Ali S, Trepel D, Collingridge Moore D, Littlewood E, McMillan D. Social Stories in mainstream schools for children with autism spectrum disorder: a feasibility randomised controlled trial. BMJ Open 2016; 6:e011748. [PMID: 27515756 PMCID: PMC4985921 DOI: 10.1136/bmjopen-2016-011748] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To assess the feasibility of recruitment, retention, outcome measures and intervention training/delivery among teachers, parents and children. To calculate a sample size estimation for full trial. DESIGN A single-centre, unblinded, cluster feasibility randomised controlled trial examining Social Stories delivered within a school environment compared with an attentional control. SETTING 37 primary schools in York, UK. PARTICIPANTS 50 participants were recruited and a cluster randomisation approach by school was examined. Participants were randomised into the treatment group (n=23) or a waiting list control group (n=27). OUTCOME MEASURES Acceptability and feasibility of the trial, intervention and of measurements required to assess outcomes in a definitive trial. RESULTS An assessment of the questionnaire completion rates indicated teachers would be most appropriate to complete the primary outcome measure. 2 outcome measures: the Social Responsiveness Scale (SRS)-2 and a goal-based measure showed both the highest levels of completion rates (above 80%) at the primary follow-up point (6 weeks postintervention) and captured relevant social and behaviour outcomes. Power calculations were based on these 2 outcome measures leading to a total proposed sample size of 180 participant groups. CONCLUSIONS Results suggest that a future trial would be feasible to conduct and could inform the policy and practice of using Social Stories in mainstream schools. TRIAL REGISTRATION NUMBER ISRCTN96286707; Results.
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Affiliation(s)
| | | | | | - Joy Adamson
- Department of Health Sciences, University of York, York, UK
| | | | | | - Liz Cook
- Department of Health Sciences, University of York, York, UK
| | | | | | - Paul Dempster
- Department of Health Sciences, University of York, York, UK
| | - Shehzad Ali
- Department of Health Sciences, University of York, York, UK
| | - Dominic Trepel
- Department of Health Sciences, University of York, York, UK
| | | | | | - Dean McMillan
- Department of Health Sciences, University of York, York, UK
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15
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A Sexuality and Relationship Training Program for Women with Intellectual Disabilities: A Social Story Approach. SEXUALITY AND DISABILITY 2016. [DOI: 10.1007/s11195-016-9450-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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16
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Simut R, Costescu CA, Vanderfaeillie J, van de Perre G, Vanderborght B, Lefeber D. “Can You Cure me? Children With Autism Spectrum Disorders Playing a Doctor Game With a Social Robot”. INTERNATIONAL JOURNAL OF SCHOOL HEALTH 2016. [DOI: 10.17795/intjsh-29584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Tanner K, Hand BN, O'Toole G, Lane AE. Effectiveness of Interventions to Improve Social Participation, Play, Leisure, and Restricted and Repetitive Behaviors in People With Autism Spectrum Disorder: A Systematic Review. Am J Occup Ther 2015; 69:6905180010p1-12. [PMID: 26356653 DOI: 10.5014/ajot.2015.017806] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
People with autism spectrum disorder (ASD) commonly experience difficulties with social participation, play, and leisure along with restricted and repetitive behaviors that can interfere with occupational performance. The objective of this systematic review was to evaluate current evidence for interventions within the occupational therapy scope of practice that address these difficulties. Strong evidence was found that social skills groups, the Picture Exchange Communication System, joint attention interventions, and parent-mediated strategies can improve social participation. The findings were less conclusive for interventions to improve play and leisure performance and to decrease restricted and repetitive behaviors, but several strategies showed promise with moderately strong supporting evidence. Occupational therapists should be guided by evidence when considering interventions to improve social participation, play, leisure, and restricted and repetitive behaviors in people with ASD. Additional research using more robust scientific methods is needed for many of the currently available strategies.
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Affiliation(s)
- Kelly Tanner
- Kelly Tanner, PhD, OTR/L, is Occupational Therapy Research Coordinator, Nationwide Children's Hospital, Columbus, OH, and Lecturer, Occupational Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus;
| | - Brittany N Hand
- Brittany N. Hand, MOT, OTR/L, is PhD Student, Occupational Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | - Gjyn O'Toole
- Gjyn O'Toole, MEdStud, GradDip TEFL, BA, Dip Occ Therapy, is Senior Lecturer, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Alison E Lane
- Alison E. Lane, PhD, OTR/L, is Associate Professor, University of Newcastle, Callaghan, New South Wales, Australia
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Simut RE, Vanderfaeillie J, Peca A, Van de Perre G, Vanderborght B. Children with Autism Spectrum Disorders Make a Fruit Salad with Probo, the Social Robot: An Interaction Study. J Autism Dev Disord 2015; 46:113-126. [DOI: 10.1007/s10803-015-2556-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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19
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Costescu CA, Vanderborght B, David DO. Reversal Learning Task in Children with Autism Spectrum Disorder: A Robot-Based Approach. J Autism Dev Disord 2014; 45:3715-25. [DOI: 10.1007/s10803-014-2319-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Fletcher‐Watson S, McConnell F, Manola E, McConachie H. Interventions based on the Theory of Mind cognitive model for autism spectrum disorder (ASD). Cochrane Database Syst Rev 2014; 2014:CD008785. [PMID: 24652601 PMCID: PMC6923148 DOI: 10.1002/14651858.cd008785.pub2] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The 'Theory of Mind' (ToM) model suggests that people with autism spectrum disorder (ASD) have a profound difficulty understanding the minds of other people - their emotions, feelings, beliefs, and thoughts. As an explanation for some of the characteristic social and communication behaviours of people with ASD, this model has had a significant influence on research and practice. It implies that successful interventions to teach ToM could, in turn, have far-reaching effects on behaviours and outcome. OBJECTIVES To review the efficacy of interventions based on the ToM model for individuals with ASD. SEARCH METHODS In August 2013 we searched CENTRAL, Ovid MEDLINE, Embase, CINAHL, PsycINFO, ERIC, Social Services Abstracts, AutismData, and two trials registers. We also searched the reference lists of relevant papers, contacted authors who work in this field, and handsearched a number of journals. SELECTION CRITERIA Review studies were selected on the basis that they reported on an applicable intervention (linked to ToM in one of four clearly-defined ways), presented new randomised controlled trial data, and participants had a confirmed diagnosis of an autism spectrum disorder. Studies were selected by two review authors independently and a third author arbitrated when necessary. DATA COLLECTION AND ANALYSIS Risk of bias was evaluated and data were extracted by two review authors independently; a third author arbitrated when necessary. Most studies were not eligible for meta-analysis, the principal reason being mis-matching methodologies and outcome measures. Three small meta-analyses were carried out. MAIN RESULTS Twenty-two randomised trials were included in the review (N = 695). Studies were highly variable in their country of origin, sample size, participant age, intervention delivery type, and outcome measures. Risk of bias was variable across categories. There were very few studies for which there was adequate blinding of participants and personnel, and some were also judged at high risk of bias in blinding of outcome assessors. There was also evidence of some bias in sequence generation and allocation concealment. Not all studies reported data that fell within the pre-defined primary outcome categories for the review, instead many studies reported measures which were intervention-specific (e.g. emotion recognition). The wide range of measures used within each outcome category and the mixed results from these measures introduced further complexity when interpreting results.Studies were grouped into four main categories according to intervention target/primary outcome measure. These were: emotion recognition studies, joint attention and social communication studies, imitation studies, and studies teaching ToM itself. Within the first two of these categories, a sub-set of studies were deemed suitable for meta-analysis for a limited number of key outcomes.There was very low quality evidence of a positive effect on measures of communication based on individual results from three studies. There was low quality evidence from 11 studies reporting mixed results of interventions on measures of social interaction, very low quality evidence from four studies reporting mixed results on measures of general communication, and very low quality evidence from four studies reporting mixed results on measures of ToM ability. The meta-analysis results we were able to generate showed that interventions targeting emotion recognition across age groups and working with people within the average range of intellectual ability had a positive effect on the target skill, measured by a test using photographs of faces (mean increase of 0.75 points, 95% confidence interval (CI) 0.22 to 1.29 points, Z = 2.75, P < 0.006, four studies, N = 105). Therapist-led joint attention interventions can promote production of more joint attention behaviours within adult-child interaction (mean increase of 0.55 points, 95% CI 0.11 to 0.99 points, Z = 2.45, P value = 0.01, two studies, N = 88). Further analysis undermines this conclusion somewhat by demonstrating that there was no clear evidence that intervention can have an effect on joint attention initiations as measured using a standardised assessment tool (mean increase of 0.23 points, 95% CI -0.48 to 0.94 points, Z = 0.63, P value = 0.53, three studies, N = 92). No adverse effects were apparent. AUTHORS' CONCLUSIONS While there is some evidence that ToM, or a precursor skill, can be taught to people with ASD, there is little evidence of maintenance of that skill, generalisation to other settings, or developmental effects on related skills. Furthermore, inconsistency in findings and measurement means that evidence has been graded of 'very low' or 'low' quality and we cannot be confident that suggestions of positive effects will be sustained as high-quality evidence accumulates. Further longitudinal designs and larger samples are needed to help elucidate both the efficacy of ToM-linked interventions and the explanatory value of the ToM model itself. It is possible that the continuing refinement of the ToM model will lead to better interventions which have a greater impact on development than those investigated to date.
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Affiliation(s)
- Sue Fletcher‐Watson
- University of EdinburghMoray House School of EducationSt John's LandHolyrood RoadEdinburghUKEH8 8AQ
| | - Fiona McConnell
- University of EdinburghMoray House School of EducationSt John's LandHolyrood RoadEdinburghUKEH8 8AQ
| | - Eirini Manola
- Puzzle ‐ School for Children with AutismAmarousiou‐Chalandriou 108, MarousiAthensGreece15125
| | - Helen McConachie
- Newcastle UniversityInstitute of Health and SocietyNewcastle upon TyneUKNE1 4LP
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Hutchins TL, Prelock PA. Using communication to reduce challenging behaviors in individuals with autism spectrum disorders and intellectual disability. Child Adolesc Psychiatr Clin N Am 2014; 23:41-55. [PMID: 24231166 DOI: 10.1016/j.chc.2013.07.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This article describes the relationship between expressive communication impairments and common challenging behaviors in individuals with Autism Spectrum Disorder and Intellectual Disability. The communication challenges of individuals with Autism Spectrum Disorder/Intellectual Disability are described and several evidence-based intervention strategies are proposed to support communication so as to decrease challenging behaviors. Recommendations for practice are offered.
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Affiliation(s)
- Tiffany L Hutchins
- Department of Communication Sciences and Disorders, University of Vermont, 407 Pomeroy Hall, 489 Main Street, Burlington, VT 05405, USA.
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Walton KM, Ingersoll BR. Improving social skills in adolescents and adults with autism and severe to profound intellectual disability: a review of the literature. J Autism Dev Disord 2013; 43:594-615. [PMID: 22790427 DOI: 10.1007/s10803-012-1601-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Social skills are important treatment targets for individuals with autism spectrum disorders (ASD) across the lifespan. However, few treatments are available for adolescents and adults with ASD who also have severe to profound intellectual disability (S/PID). Several social skill interventions have been described that may improve social skills in this population, including video modeling, developmental, peer-mediated, behavioral, and structured teaching interventions. However, significant challenges in research design and methodology exist across these studies. This paper reviews research examining social skill interventions for youth and adults with ASD and S/PID and points out weaknesses and challenges in this literature. We propose a developmental framework of adapting early childhood interventions for use with youth and adults with ASD and S/PID as one starting point for intervention development.
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Affiliation(s)
- Katherine M Walton
- Department of Psychology, 69F Psychology, Michigan State University, East Lansing, MI 48824, USA.
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Hutchins TL, Prelock PA. The social validity of Social Stories™ for supporting the behavioural and communicative functioning of children with autism spectrum disorder. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2013; 15:383-395. [PMID: 23216418 DOI: 10.3109/17549507.2012.743174] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study examines the social validity of a family-centred collaborative approach to developing Social Stories™ to support the behavioural and communicative functioning of children with autism spectrum disorder (ASD). Twenty children with Pervasive Developmental Disorder (PDD)/Autism, PDD-Not Otherwise Specified, or Asperger's Disorder (aged 4-12 years) participated in a multiple baseline design across behaviours with a 6-week follow-up. The effects of behaviour stories (to reduce problem behaviours) and communication stories (to facilitate communication) as assessed by parental subjective perceptions of child functioning were evaluated and compared. Using daily parental ratings, behaviour stories were deemed effective for 11 of 17 stories (64.7%), whereas communication stories were deemed effective for 10 of 19 stories (52.6%), with great variability in effect size for both. Results also indicated variability in performance across specific story targets, although parents' perceived effects of Social Stories™ were not linked to any known child characteristics. This study argues that intervention using Social Stories™ to address behavioural and communicative functioning can yield socially valid outcomes across a range of child characteristics and intervention targets. Implications for clinical practice and how present methodological limitations can be addressed in future research are considered.
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Maglione MA, Gans D, Das L, Timbie J, Kasari C. Nonmedical interventions for children with ASD: recommended guidelines and further research needs. Pediatrics 2012; 130 Suppl 2:S169-78. [PMID: 23118248 DOI: 10.1542/peds.2012-0900o] [Citation(s) in RCA: 146] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To use the findings of a systematic review of scientific evidence to develop consensus guidelines on nonmedical interventions that address cognitive function and core deficits in children with autism spectrum disorders (ASDs) and to recommend priorities for future research. METHODS The guidelines were developed by a Technical Expert Panel (TEP) consisting of practitioners, researchers, and parents. A systematic overview of research findings was presented to the TEP; guideline statements were drafted, discussed, debated, edited, reassessed, and presented for formal voting. RESULTS The strength of evidence of efficacy varied by intervention type from insufficient to moderate. There was some evidence that greater intensity of treatment (hours per week) and greater duration (in months) led to better outcomes. The TEP agreed that children with ASD should have access to at least 25 hours per week of comprehensive intervention to address social communication, language, play skills, and maladaptive behavior. They agreed that applied behavioral analysis, integrated behavioral/developmental programs, the Picture Exchange Communication System, and various social skills interventions have shown efficacy. Based on identified gaps, they recommend that future research focus on assessment and monitoring of outcomes, addressing the needs of pre/nonverbal children and adolescents, and identifying the most effective strategies, dose, and duration to improve specific core deficits. CONCLUSIONS The creation of treatment guidelines and recommendations for future research represents an effort by leading experts to improve access to services for children with ASDs while acknowledging that the research evidence has many gaps.
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Affiliation(s)
- Margaret A Maglione
- Southern California Evidence-based Practice Center, RAND Corporation, 1776 Main St, Mailstop 4W, Santa Monica, CA 90407, USA
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Carter EJ, Williams DL, Minshew NJ, Lehman JF. Is he being bad? Social and language brain networks during social judgment in children with autism. PLoS One 2012; 7:e47241. [PMID: 23082151 PMCID: PMC3474836 DOI: 10.1371/journal.pone.0047241] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 09/11/2012] [Indexed: 11/19/2022] Open
Abstract
Individuals with autism often violate social rules and have lower accuracy in identifying and explaining inappropriate social behavior. Twelve children with autism (AD) and thirteen children with typical development (TD) participated in this fMRI study of the neurofunctional basis of social judgment. Participants indicated in which of two pictures a boy was being bad (Social condition) or which of two pictures was outdoors (Physical condition). In the within-group Social-Physical comparison, TD children used components of mentalizing and language networks [bilateral inferior frontal gyrus (IFG), bilateral medial prefrontal cortex (mPFC), and bilateral posterior superior temporal sulcus (pSTS)], whereas AD children used a network that was primarily right IFG and bilateral pSTS, suggesting reduced use of social and language networks during this social judgment task. A direct group comparison on the Social-Physical contrast showed that the TD group had greater mPFC, bilateral IFG, and left superior temporal pole activity than the AD group. No regions were more active in the AD group than in the group with TD in this comparison. Both groups successfully performed the task, which required minimal language. The groups also performed similarly on eyetracking measures, indicating that the activation results probably reflect the use of a more basic strategy by the autism group rather than performance disparities. Even though language was unnecessary, the children with TD recruited language areas during the social task, suggesting automatic encoding of their knowledge into language; however, this was not the case for the children with autism. These findings support behavioral research indicating that, whereas children with autism may recognize socially inappropriate behavior, they have difficulty using spoken language to explain why it is inappropriate. The fMRI results indicate that AD children may not automatically use language to encode their social understanding, making expression and generalization of this knowledge more difficult.
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Affiliation(s)
- Elizabeth J Carter
- Robotics Institute, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA.
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Styles A. Social StoriesTM: does the research evidence support the popularity? EDUCATIONAL PSYCHOLOGY IN PRACTICE 2011. [DOI: 10.1080/02667363.2011.624312] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Zur Bedeutung der Bibliotherapie und des expressiven Schreibens in der Kinder- und Jugendpsychiatrie. Prax Kinderpsychol Kinderpsychiatr 2011; 60:109-24. [DOI: 10.13109/prkk.2011.60.2.109] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Solomon M, Buaminger N, Rogers SJ. Abstract reasoning and friendship in high functioning preadolescents with autism spectrum disorders. J Autism Dev Disord 2011; 41:32-43. [PMID: 20467797 PMCID: PMC3005120 DOI: 10.1007/s10803-010-1017-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
To investigate the relationship between cognitive and social functioning, 20 Israeli individuals with HFASD aged 8-12 and 22 age, maternal education, and receptive vocabulary-matched preadolescents with typical development (TYP) came to the lab with a close friend. Measures of abstract reasoning, friendship quality, and dyadic interaction during a play session were obtained. As hypothesized, individuals with HFASD were significantly impaired in abstract reasoning, and there were significant group differences in friend and observer reports of friendship quality. There also was consistency in reports between friends. Two factors-"relationship appearance" and "relationship quality" described positive aspects of the relationships. Disability status and age related to relationship appearance. Proband abstract reasoning was related to relationship quality.
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Affiliation(s)
- Marjorie Solomon
- Department of Psychiatry and Behavioral Science, University of California, Davis, Sacramento, CA, USA.
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Abstract
PURPOSE OF REVIEW The review explores current trends in the behavioral intervention literature for children with an autism spectrum disorder (ASD) during 2008 and 2009. Noteworthy findings and intervention strategies are highlighted. Additionally, the quality of all reviewed studies is systematically evaluated. RECENT FINDINGS During 2008 and 2009, there was nearly a quarter increase in the number of behavioral intervention studies, as well as more randomized controlled trials and approaches other than applied behavior analysis. Many of the studies investigated commonly used ASD intervention practices or novel treatments. A few were conducted with underserved populations, such as toddlers and adults with ASD. Social impairment was the focus of the largest number of intervention studies. A small percentage of studies were rated as high-quality. SUMMARY Overall, the reviewed studies suggest that ASD-specific deficits can be improved through behavioral intervention. However, whereas progress continues to be made in our understanding of effective treatments for children with ASD, confidence in these findings would be improved with higher-quality studies.
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