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Narzisi A, Sesso G, Fabbri-Destro M, Berloffa S, Fantozzi P, Muccio R, Bruzzi G, Scatigna S, Valente E, Viglione V, Milone A, Cortese S, Masi G. Social Skills Interventions for Adolescents with Level 1 Autism Spectrum Disorder: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. CLINICAL NEUROPSYCHIATRY 2024; 21:169-181. [PMID: 38988677 PMCID: PMC11231730 DOI: 10.36131/cnfioritieditore20240302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
Objective Evidence on the efficacy of social skills training for adolescents with Level 1 Autism Spectrum Disorder (ASD) is unclear. Method We searched Pubmed, Scopus, and Web of Science until July 27th, 2023, for randomized controlled trials (RCTs) of social skills training for pre-adolescents and adolescents (aged 9-18) with Level 1 ASD. We then pooled data on efficacy from individual RCTs by conducting multivariate mixed-effects meta-analyses in R. We estimated possible bias in the retained RCTs using the RoB2 tool. Results We retained 36 RCTs (encompassing 2796 participants), including 18 RCTs comparing an experimental treatment to a waiting list, and 18 RCTs comparing it to standard care/control treatment. Meta-analyses showed that experimental treatments were significantly more efficacious than waiting list or standard care/ control treatments in improving social skills (SMD = 0.3745; 95%CI = [0.2396; 0.5093]), as well as reducing behavioral symptoms (0.3154;0.1783, 0.4525) and anxious/depressive symptoms (0.2780; 0.0432, 0.5128). However, for some outcomes there was significant heterogeneity across studies and evidence of publication bias. Subgroup analyses and meta-regressions did not identify any specific clinical or demographic factors as significant predictors of outcome. The most common risk of bias across studies was related to deviations from intended interventions and measurement of the outcomes. Conclusions At the group level, social skills training for adolescents with Level 1 ASD is efficacious, with small-to-moderate effect size. Future research should focus on personalized medicine approaches, aimed at tailoring interventions to specific characteristics of adolescents with Level 1 ASD.
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Affiliation(s)
- Antonio Narzisi
- Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, 56128 Pisa, Italy
| | - Gianluca Sesso
- Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, 56128 Pisa, Italy
- Social and Affective Neuroscience (SANe) Group, Molecular Mind Lab, IMT School for Advanced Studies of Lucca, Lucca, Italy
| | | | - Stefano Berloffa
- Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, 56128 Pisa, Italy
| | - Pamela Fantozzi
- Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, 56128 Pisa, Italy
| | - Rosy Muccio
- Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, 56128 Pisa, Italy
| | - Gianina Bruzzi
- Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, 56128 Pisa, Italy
| | - Stefano Scatigna
- Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, 56128 Pisa, Italy
| | - Elena Valente
- Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, 56128 Pisa, Italy
| | - Valentina Viglione
- Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, 56128 Pisa, Italy
| | - Annarita Milone
- Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, 56128 Pisa, Italy
| | - Samuele Cortese
- Centre for Innovation in Mental Health (CIMH), School of Psychology, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, USA
- DiMePRe-J-Department of Precision and Rigenerative Medicine-Jonic Area, University of Bari "Aldo Moro", Bari, Italy
| | - Gabriele Masi
- Department of Child Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, 56128 Pisa, Italy
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Ma Z, Fu W, Gu P, Siting H, Liujing Y, Zhou W. Parental Perception of the Importance of Friendship and Other Educational Outcomes in Children with Autism Spectrum Disorder in China. J Autism Dev Disord 2024; 54:2012-2025. [PMID: 36961612 DOI: 10.1007/s10803-023-05954-3] [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] [Accepted: 02/27/2023] [Indexed: 03/25/2023]
Abstract
This study examined parental perception of the importance of friendship and five other educational outcomes from 101 Chinese parents of children with autism spectrum disorders between the ages of 3 and 12 years. Results showed Chinese parents considered friendship less important than social skills, emotional development, and physical skills and motor development. Unlike the results from previous studies, Chinese parents ranked friendship as the second least important outcome. Children's age rather than educational setting impacted parental perceptions. The findings suggested cultural contexts may have influenced parental perceptions of the importance of different educational outcomes, and future research on the influence of cultural contexts is warranted.
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Affiliation(s)
- Zijie Ma
- Department of Special Education, University of Kansas, Lawrence, USA
| | - Wangqian Fu
- Faculty of Education, Beijing Normal University, Beijing, China
| | - Peidi Gu
- College of Education for the Future, Beijing Normal University, Zhuhai, China.
| | - He Siting
- College of Education for the Future, Beijing Normal University, Zhuhai, China
| | - Yang Liujing
- College of Education for the Future, Beijing Normal University, Zhuhai, China
| | - Wei Zhou
- Faculty of Education, Beijing Normal University, Beijing, China
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Crowe CL, Liu L, Bagnarol N, Fried LP. Loneliness prevention and the role of the Public Health system. Perspect Public Health 2024; 144:31-38. [PMID: 35815809 DOI: 10.1177/17579139221106579] [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: 11/16/2022]
Abstract
AIMS To evaluate evidence on loneliness interventions that have been assessed and found effective, both for remediation and addressing fundamental causes of loneliness; to consider why population-level primary prevention strategies targeting fundamental causes are necessary, and determine areas for future research; and to outline an integrated approach to prevention considering roles for the Public Health system. METHOD We conducted a review of systematic reviews to identify effective loneliness interventions and classified them in our Population-Prevention Matrix according to public health impact, amount of individual effort required, and level of prevention. We also highlighted emerging interventions that have yet to be formally evaluated. RESULTS We identified a range of preventive or therapeutic approaches, and a dearth of population-level primary prevention interventions targeting fundamental causes of loneliness. Filling this gap will be essential in addressing the loneliness epidemic, and we provided emerging examples of population-level primary prevention interventions that may inform future efforts. CONCLUSION Based on evidence to date, we suggest an integrated approach to prevention with significant roles for the US Public Health system, including its function as Chief Health Strategist to lead and guide multisystem approaches to loneliness prevention, with a particular focus on population-level primary prevention strategies.
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Affiliation(s)
- C L Crowe
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W. 168th Street, New York, NY 10032, USA
| | - L Liu
- Columbia University Mailman School of Public Health, New York, NY, USA*; National University Health System, Singapore
| | - N Bagnarol
- Columbia University Mailman School of Public Health, New York, NY, USA; New York City Health and Hospitals, New York, NY, USA
| | - L P Fried
- Dean and DeLamar Professor of Public Health, Columbia University Mailman School of Public Health, New York, NY, USA
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Wright B, Kingsley E, Cooper C, Biggs K, Bursnall M, Wang HI, Chater T, Coates E, Teare MD, McKendrick K, Gomez de la Cuesta G, Barr A, Solaiman K, Packham A, Marshall D, Varley D, Nekooi R, Parrott S, Ali S, Gilbody S, Le Couteur A. Play brick therapy to aid the social skills of children and young people with autism spectrum disorder: the I-SOCIALISE cluster RCT. PUBLIC HEALTH RESEARCH 2023; 11:1-137. [PMID: 38095124 DOI: 10.3310/vgtr7431] [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: 12/18/2023] Open
Abstract
Background Social skills interventions are commonly recommended to help children and young people with autism spectrum disorder develop social skills, but some struggle to engage in these interventions. LEGO® (LEGO System A/S, Billund, Denmark) based therapy, a group social skills intervention, aims to be more interesting and engaging. Objective To evaluate the clinical effectiveness of LEGO® based therapy on the social and emotional skills of children and young people with autism spectrum disorder in school settings compared with usual support. Secondary objectives included evaluations of cost-effectiveness, acceptability and treatment fidelity. Design A cluster randomised controlled trial randomly allocating participating schools to either LEGO® based therapy and usual support or usual support only. Setting Mainstream schools in the north of England. Participants Children and young people (aged 7-15 years) with autism spectrum disorder, their parent/guardian, an associated teacher/teaching assistant and a facilitator teacher/teaching assistant (intervention schools only). Intervention Schools randomised to the intervention arm delivered 12 weekly sessions of LEGO® based therapy, which promotes collaborative play and encourages social problem-solving in groups of three children and young people with a facilitator (trained teacher or teaching assistant). Participants received usual support from school and community services. Participants in the control arm received usual support only. Research assistants and statisticians were blind to treatment allocation. Main outcome measure The social skills subscale of the Social Skills Improvement System (SSIS), completed by the children and young people's unblinded teacher pre randomisation and 20 weeks post randomisation. The SSIS social skills subscale measures social skills including social communication, co-operation, empathy, assertion, responsibility and self-control. Participants completed a number of other pre- and post-randomisation measures of emotional health, quality of life, loneliness, problem behaviours, academic competence, service resource utilisation and adverse events. Results A total of 250 children and young people from 98 schools were randomised: 127 to the intervention arm and 123 to the control arm. Intention-to-treat analysis of the main outcome measure showed a modest positive difference of 3.74 points (95% confidence interval -0.16 to 7.63 points, standardised effect size 0.18; p = 0.06) in favour of the intervention arm. Statistical significance increased in per-protocol analysis, with a modest positive difference (standardised effect size 0.21; p = 0.036). Cost-effectiveness of the intervention was found in reduced service use costs and a small increase in quality-adjusted life-years. Intervention fidelity and acceptability were positive. No intervention-related adverse events or effects were reported. Conclusions The primary and pre-planned sensitivity analysis of the primary outcome consistently showed a positive clinical difference, with modest standardised effect sizes of between 0.15 and 0.21. There were positive health economics and qualitative findings, corroborated by the difference between arms for the majority of secondary outcomes, which were not statistically significant but favoured the intervention arm. Post hoc additional analysis was exploratory and was not used in drawing this conclusion. Given the small positive change, LEGO® based therapy for children and young people with autism spectrum disorder in schools should be considered. Limitations The primary outcome measure was completed by an unblinded teacher (rather than by the facilitator). Future work The study team recommends future research into LEGO® based therapy, particularly in school environments. Trial registration This trial is registered as ISRCTN64852382. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 15/49/32) and is published in full in Public Health Research; Vol. 11, No. 12. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Barry Wright
- Hull York Medical School, University of York, York, UK
- Child Oriented Mental Health Innovation Collaborative, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - Ellen Kingsley
- Child Oriented Mental Health Innovation Collaborative, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - Cindy Cooper
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Katie Biggs
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Matthew Bursnall
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Han-I Wang
- Hull York Medical School, University of York, York, UK
| | - Tim Chater
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Elizabeth Coates
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - M Dawn Teare
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Kirsty McKendrick
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | - Amy Barr
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Kiera Solaiman
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Anna Packham
- Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | | | - Roshanak Nekooi
- Child Oriented Mental Health Innovation Collaborative, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - Steve Parrott
- Hull York Medical School, University of York, York, UK
| | - Shehzad Ali
- Hull York Medical School, University of York, York, UK
| | - Simon Gilbody
- Hull York Medical School, University of York, York, UK
| | - Ann Le Couteur
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Gates JA, McNair ML, Richards JK, Lerner MD. Social Knowledge & Performance in Autism: A Critical Review & Recommendations. Clin Child Fam Psychol Rev 2023; 26:665-689. [PMID: 37544969 PMCID: PMC10613329 DOI: 10.1007/s10567-023-00449-0] [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: 07/24/2023] [Indexed: 08/08/2023]
Abstract
Autistic social challenges have long been assumed to arise from a lack of social knowledge ("not knowing what to do"), which has undergirded theory and practice in assessment, treatment, and education. However, emerging evidence suggests these differences may be better accounted for by difficulties with social performance ("doing what they may know"). This distinction has important implications for research, practice, policy, and community support of autistic people. This review examines the theoretical and clinical implications and empirical status of the knowledge-performance distinction in autism. Current evidence suggests that social knowledge deficits are neither definitional nor reliably related to outcomes in autism. Prioritizing social knowledge, then, may produce unanticipated, problematic consequences in terms of accuracy of assessment, intervention effectiveness, and promotion of stigma. It may also yield unrealistic expectations around the value of knowledge for autistic people and their families, yielding important ethical considerations. Conversely, recent evidence highlights performance-related factors as being especially promising for better modeling and addressing social challenges in autism. Prioritizing performance, then, may offer new directions for assessment, substantially different intervention opportunities, and novel methods of inclusion and affirmation. This review touches upon each of these domains and implications, integrates these developments with broader models of social competence in youth, and provides direction for future research and practice regarding social competence in autism.
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Affiliation(s)
| | | | | | - Matthew D Lerner
- Stony Brook University, Stony Brook, USA.
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA.
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Arnardóttir ÁÁ, Guðmundsdóttir LÁ, Hannesdóttir DK, Halldórsson F, Auðardóttir H, Sveinbjörnsdóttir B. A Pilot Study on the FEST program - Friendship and Emotional Skills Training for Children on the Autism Spectrum. J Autism Dev Disord 2023:10.1007/s10803-023-06099-z. [PMID: 37642875 DOI: 10.1007/s10803-023-06099-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Social skills difficulties among children on the autism spectrum can impede social, emotional, and academic development, especially with increasing age and social demands. This pilot study examined the efficacy of a 5-week skill-building program for children on the autism spectrum. Although effective social skills programs are available for adolescents with autism spectrum disorder (ASD), very few programs are explicitly intended for 10-12-year-old children. METHODS This pilot study examined the efficacy of the 9-session Friendship and Emotional Skills Training (FEST Program) for children with ASD without intellectual disability. Participants were 22 children randomly assigned to the FEST Program or a delayed intervention control group. Eleven children (boys = 8; girls = 3) received the FEST Program in two separate groups, and 11 were wait-listed for a delayed intervention. Parents, teachers, and the children answered questionnaires at baseline, post-intervention, and a 3-month follow-up. RESULTS Upon completing the FEST Program (post-intervention), parents reported an increase in overall social skills (on the Social Skills Rating System - SSRS) and a reduction on the Autistic Mannerisms factor (on the Social Responsiveness Scale - SRS) compared to the control group. These changes were also maintained at the 3-month follow-up. The children's assessment also showed a significant increase in assertion (on the SSRS) post-intervention. Teachers also reported a significant reduction on the Autistic Mannerisms factor at the 3-month follow-up. CONCLUSION The findings suggest that the FEST Program shows some promising results as one possibility for supporting children with ASD and their families in everyday life.
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Affiliation(s)
- Ágústa Á Arnardóttir
- The National Agency for Children and Families (Barna- og fjölskyldustofa), Reykjavik, Iceland.
| | - Laufey Á Guðmundsdóttir
- Children´s Mental Health Center for the Primary Health Care of the Capital Area (Gedheilsumistod barna Heilsugaeslu hofudborgarsvaedisins), Reykjavik, Iceland
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - Dagmar Kr Hannesdóttir
- Children´s Mental Health Center for the Primary Health Care of the Capital Area (Gedheilsumistod barna Heilsugaeslu hofudborgarsvaedisins), Reykjavik, Iceland
- Department of Psychology, University of Iceland, Reykjavik, Iceland
| | - Freyr Halldórsson
- Department of Business Administration, Reykjavik University, Reykjavik, Iceland
| | - Helga Auðardóttir
- SOL clinic - Psychological and medical services for families, Kopavogur, Iceland
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Hatch B, Kadlaskar G, Miller M. Diagnosis and treatment of children and adolescents with autism and ADHD. PSYCHOLOGY IN THE SCHOOLS 2023; 60:295-311. [PMID: 37065905 PMCID: PMC10092654 DOI: 10.1002/pits.22808] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/11/2022] [Accepted: 09/11/2022] [Indexed: 11/12/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and autism are neurodevelopmental disorders that emerge in childhood. There is increasing recognition that ADHD and autism frequently co-occur. Yet, questions remain among clinicians regarding the best ways to evaluate and treat co-occurring autism and ADHD. This review outlines issues relevant to providing evidence-based practice to individuals and families who may be experiencing difficulties associated with co-occurring autism and ADHD. After describing the complexities of the co-occurrence of autism and ADHD, we present practical considerations for best practice assessment and treatment of co-occurring autism and ADHD. Regarding assessment, this includes considerations for interviewing parents/caregivers and youth, using validated parent and teacher rating scales, conducting cognitive assessments, and conducting behavior observations. Regarding treatment, consideration is given to behavioral management, school-based interventions, social skills development, and the use of medications. Throughout, we note the quality of evidence that supports a particular component of assessment or treatment, highlighting when evidence is most relevant to those with co-occurring autism and ADHD across stages of development. In light of the current evidence for assessment and treatment of co-occurring autism and ADHD, we conclude by outlining practical implications for clinical and educational practice.
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Affiliation(s)
- Burt Hatch
- School of PsychologyVictoria University of WellingtonWellingtonNew Zealand
| | - Girija Kadlaskar
- Department of Psychiatry & Behavioral Sciences and MIND InstituteUniversity of CaliforniaDavisCaliforniaUSA
| | - Meghan Miller
- Department of Psychiatry & Behavioral Sciences and MIND InstituteUniversity of CaliforniaDavisCaliforniaUSA
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Im-Bolter N, de la Roche L. What parents want: A qualitative analysis of a parent-implemented intervention for autistic children. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2023; 8:23969415231189606. [PMID: 37546520 PMCID: PMC10399253 DOI: 10.1177/23969415231189606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Background and aims Guidelines regarding social cognitive interventions for autistic children suggest incorporating a holistic approach. This includes increasing the family's understanding of difficulties associated with autism, integrations of natural environments, and parents as active agents in the intervention while being supported for their well-being. The current availability of holistic parent-implemented interventions for autistic children is limited, with no qualitative understanding of how parents view the benefits for themselves or their children. Method The current study expands the literature regarding holistic approaches through a qualitative understanding of parent perceptions of a parent-implemented social communication intervention for autistic children (TalkAbility™), which incorporates a 6-month follow-up. This study sought to gain a deeper understanding from parents on their perceptions of a holistic approach, including the impact on themselves, their families, and their autistic child. Results Following Braun and Clarke's model of thematic analysis, data was coded into four themes: (a) communication difficulties, frustrations, and progress, (b) social relationships and concerns, (c) communication strategies, and (d) thoughts and emotions surrounding TalkAbility™. Conclusions Parents report that many components of a holistic approach are instrumental in encouraging social communication in their autistic child. Results highlight the importance of considering parent experiences regarding interventions for their child's social communication skills through a qualitative viewpoint. Implications Knowing the intervention aspects that parents view as most valuable allows targeted program modifications that reflect actual parent needs. Further understanding regarding the influence of holistic parent-implemented social communication interventions on child communication skills, parenting frustrations, and parent-child relationships is needed.
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Affiliation(s)
- Nancie Im-Bolter
- Department of Psychology, Trent University, Peterborough, ON, Canada; Department of Psychology, Queen's University, Kingston, ON, Canada
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Dean M, Chang YC, Shih W, Orlich F, Kasari C. Social engagement and loneliness in school-age autistic girls and boys. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231170973. [PMID: 37129160 PMCID: PMC10159247 DOI: 10.1177/17455057231170973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 03/28/2023] [Accepted: 04/04/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVES This study examines the relationship between social engagement and loneliness in female and male autistic children and adolescents in school-based social settings. Secondary aims sought to explore the emergence of loneliness across different age groups and differences in social engagement and loneliness between genders. METHODS This study conducted an analysis of previously collected data from two multi-site randomized control trials. This study included 58 autistic students (29 females, 29 males) between the ages 6 through 18 years. Female and male participants were matched on age and intelligence quotient. Concurrent mixed methods were used to examine participants' social engagement and loneliness. RESULTS Findings revealed a significant relationship between joint engagement and loneliness, such that autistic students reported more loneliness when they were mutually engaged with social groups than when they were isolated or alone. Positive correlations between joint engage and loneliness were identified in elementary-age girls and secondary-age boys, suggesting that being mutually engaged with peers leads to increased loneliness. Negative correlations between parallel and loneliness identified in secondary-age boys suggested that boys in close proximity to peers felt less lonely than boys who were mutually engaged with peers. Qualitative analysis of social behaviors indicated that elementary girls and secondary boys were more likely to be mutually engaged or in close proximity to activities, but they had difficulty sustaining this engagement throughout the entire social period. Secondary girls and elementary boys, on the other hand, were more likely to be solitary and less likely to engage with peer groups. CONCLUSION Study findings highlight the relationship between social engagement and loneliness in school-based autistic populations, and that more engagement itself can lead to more loneliness for younger girls and older boys. The influence of age and gender on engagement and loneliness highlights a need to tailor social interventions to leverage existing social strengths.
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Affiliation(s)
- Michelle Dean
- California State University (CSU)
Channel Islands, Camarillo, CA, USA
| | - Ya-Chih Chang
- California State University (CSU), Los
Angeles, Los Angeles, CA, USA
| | - Wendy Shih
- Center for Autism Research &
Treatment, UCLA Semel Institute, Los Angeles, CA, USA
| | - Felice Orlich
- Seattle Children’s Autism Center (CAC),
Seattle, WA, USA
| | - Connie Kasari
- Center for Autism Research &
Treatment, UCLA Semel Institute, Los Angeles, CA, USA
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Davis R, Hampton SC, Fletcher-Watson S. Why study bilingualism in autistic people? AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1601-1605. [DOI: 10.1177/13623613221126115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gilmore R, Ziviani J, Chatfield MD, Goodman S, Sakzewski L. Social skills group training in adolescents with disabilities: A systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 125:104218. [PMID: 35306461 DOI: 10.1016/j.ridd.2022.104218] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Group social skills interventions (GSSIs) are offered to youth with Autism Spectrum Disorder (ASD) to improve social functioning. This systematic review focused on the adolescent population, including a wider range of disabilities. AIMS To evaluate effectiveness of GSSIs at improving social functioning in adolescents with congenital, acquired or developmental disabilities. METHODS AND PROCEDURES Databases, trial registries and dissertations were systematically searched and a meta-analysis of randomized controlled trials conducted. Study screening, risk-of-bias assessment and Grading of Recommendations Assessment, Development and Evaluation were completed. OUTCOMES AND RESULTS Sixteen studies (n = 1119), 15 with adolescents with ASD and one with brain tumor survivors, revealed GSSIs reduced social impairment on the Social Responsiveness Scale (mean difference (MD) 9.68, 95% CI 5.63-13.73; P < 0.001), increased social skills on the Social Skill Improvement System Rating Scales (SMD 0.38, 95% CI 0.10-0.65; P = 0.007), and improved adolescent social knowledge on the Test of Adolescent Social Skills (MD 7.43 points, 95% CI 5.36-9.50; P < 0.001). CONCLUSIONS AND IMPLICATIONS There is moderate certainty evidence that GSSIs improve social responsiveness, social skills and knowledge, and low certainty of evidence to improve social participation for adolescents with ASD. High quality randomized studies are required to inform clinical practice with adolescents with other disabilities. WHAT THIS PAPER ADDS Current evidence for group social skills interventions (GSSIs) is for adolescents with autism (ASD). GSSIs likely improve social knowledge and reduce impairments in adolescents with ASD, however the effect of GSSIs on social participation is not well understood. Only one randomized trial investigated GSSIs in another population of adolescents, highlighting the need for more high-quality studies including adolescents with other disabilities.
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Affiliation(s)
- Rose Gilmore
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), Centre for Children's Health Research, Level 6, 62 Graham Street, South Brisbane, Queensland 4101, Australia; Queensland Children's Hospital, 501 Stanley Street, South Brisbane, Queensland 4101, Australia.
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, 4072, Australia
| | - Mark D Chatfield
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), Centre for Children's Health Research, Level 6, 62 Graham Street, South Brisbane, Queensland 4101, Australia
| | - Sarah Goodman
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), Centre for Children's Health Research, Level 6, 62 Graham Street, South Brisbane, Queensland 4101, Australia
| | - Leanne Sakzewski
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), Centre for Children's Health Research, Level 6, 62 Graham Street, South Brisbane, Queensland 4101, Australia
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Idris S, van Pelt BJ, Jagersma G, Duvekot J, Maras A, van der Ende J, van Haren N, Greaves-Lord K. A randomized controlled trial to examine the effectiveness of the Dutch version of the Program for the Education and Enrichment of Relational Skills (PEERS®). BMC Psychiatry 2022; 22:293. [PMID: 35459118 PMCID: PMC9034592 DOI: 10.1186/s12888-022-03913-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 03/17/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study examines the effectiveness of the culturally adapted Dutch version of The Program for the Education and Enrichment of Relational Skills (PEERS®), utilizing a randomized control trial (RCT) with an active treatment control condition. METHODS 106 adolescents with ASD, aged 12-18 years, were randomly assigned to one of two group interventions: the experimental condition (PEERS®; n = 54) or the active treatment control condition (Regulation, Organization and Autonomy Didactics; ROAD; n = 52). Effects of interventions on social skills were primarily assessed using an observational measure (CASS - Contextual Assessment Social Skills). Secondary indices of social skills were self, parent and teacher reported questionnaire data (i.e., Social Responsiveness Scale; SRS, and Social Skills Improvement System; SSIS). Treatment satisfaction was also obtained from adolescents and their parents. RESULTS Results on the observational measure of social skills revealed improvements in positive affect, overall quality of rapport, as well as starting and ending a conversation, irrespective of condition. Compared to ROAD, PEERS® participants showed increased overall self-reported social skills (SSIS). Parent reports showed decreased overall social skill impairment (SRS) as well as improved social communication (SSIS subscale), with significantly more progress in the PEERS® group. Furthermore, parents of adolescents in the PEERS® group were significantly more satisfied with the intervention (M = 8.20, SD = 1.46) than parents of adolescents in the ROAD group (M = 7.52, SD = 1.45). The self-reported treatment satisfaction of adolescents did not differ between conditions. Teacher data showed decreased social skill impairment as measured with the SRS, irrespective of condition. CONCLUSIONS This study reveals promising indications that the Dutch version of PEERS® enhances social skills in adolescents with ASD. Yet, further research is needed into how effectiveness can be optimized. TRIAL REGISTRATION Dutch trail register NTR6255 (NL6117) 08/02/2017 https://www.trialregister.nl/trial/6117.
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Affiliation(s)
- Sakinah Idris
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, 68100, Batu Caves, Selangor, Malaysia
| | - Bjorn Jaime van Pelt
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
- Yulius Organization for Mental Health, Burg. De Raadtsingel 93c, 3311 JG, Dordrecht, The Netherlands
| | - Gabrine Jagersma
- GGZ Rivierduinen Children and Youth, Institute for Mental Health, Leiden, The Netherlands
| | - Jorieke Duvekot
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - Athanasios Maras
- Yulius Organization for Mental Health, Burg. De Raadtsingel 93c, 3311 JG, Dordrecht, The Netherlands
| | - Jan van der Ende
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - Neeltje van Haren
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - Kirstin Greaves-Lord
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands.
- Yulius Organization for Mental Health, Burg. De Raadtsingel 93c, 3311 JG, Dordrecht, The Netherlands.
- Autism Team Northern-Netherlands, Jonx Department of (Youth) Mental Health and Autism of Lentis Psychiatric Institute, Groningen, The Netherlands.
- Department of Psychology, Clinical Psychology and Experimental Psychopathology Unit, University of Groningen, Groningen, The Netherlands.
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Temkin AB, Beaumont R, Wkya K, Hariton JR, Flye BL, Sheridan E, Miranda A, Vela J, Zendegui E, Schild J, Gasparro S, Loubriel D, Damiandies A, Weisman J, Silvestre A, Yadegar M, Catarozoli C, Bennett SM. Secret Agent Society: A Randomized Controlled Trial of a Transdiagnostic Youth Social Skills Group Treatment. Res Child Adolesc Psychopathol 2022; 50:1107-1119. [PMID: 35441908 DOI: 10.1007/s10802-022-00919-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 11/29/2022]
Abstract
Group programs are key for targeting social skills (SS) for children with developmental disorders and/or mental illness. Despite promising evidence regarding efficacy of group treatments, there are several limitations to current research regarding generalizability and effectiveness across diagnoses. This randomized control trial assessed whether the Secret Agent Society (SAS) group program was superior to treatment as usual (TAU) in improving social-emotional functioning for children with Attention Deficit-Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and/or anxiety. Eighty-nine youth (8-12) with ADHD, ASD, and/or an anxiety disorder receiving treatment at hospital-based outpatient clinics were randomized to receive SAS (n = 47) or TAU (n = 42) over a three-month period, at which point TAU participants were offered the SAS intervention. Parent report showed significant improvement in Emotion Regulation (ER) and Social Skills (SS) for youth in SAS vs. TAU (Fs ≥ 6.79, ps ≤ 01). Gains for the SAS condition were maintained at 6-months. Intent-to-treat analysis of teacher report indicated youth in SAS had positive gains in SS (F = 0.41, p = 0.475) and ER (F = 0.99, p = 0.322), though not significantly better than youth in TAU. Clinically reliable improvement rates were significantly higher for SAS participants than TAU for parent and teacher reported SS and ER. Improvements were significant for youth with single and comorbid diagnoses. Results suggest that SAS was superior to TAU in improving SS and ER for youth aged 8-12 with ADHD, ASD, and/or anxiety. Gains maintained in the medium-term. Trial registration number NCT02574273, registered 10/12/2015.
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Affiliation(s)
- Andrea B Temkin
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA.
| | - Renae Beaumont
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA
| | - Katarzyna Wkya
- CUNY Graduate School of Public Health, New York, NY, USA
| | - Jo R Hariton
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA
| | - Barabra L Flye
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA
| | - Elisabeth Sheridan
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA.,Drexel University (A.J. Drexel Autism Institute), Philadelphia, PA, USA
| | - Amy Miranda
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA
| | - Jamie Vela
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA.,Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Elaina Zendegui
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA.,Department of Psychiatry, Mount Sinai Hospital, New York, NY, USA
| | - Jennifer Schild
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA.,Department of Clinical Psychology, Suffolk University, Boston, MA, USA
| | - Shannon Gasparro
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA
| | - Daphne Loubriel
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA
| | - Andreas Damiandies
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA.,Touro College of Osteopathic Medicine, New York, NY, USA
| | - Julia Weisman
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA.,Department of Clinical Psychology, Hofstra University, Long Island, NY, USA
| | - Alexandra Silvestre
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA.,Columbia School of Social Work, New York, NY, USA
| | - Mina Yadegar
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA.,Rogers Behavioral Health, Los Angeles, CA, USA
| | - Corinne Catarozoli
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA
| | - Shannon M Bennett
- Department of Psychiatry, Weill Cornell Medicine/New York Presbyterian, NY, New York, USA
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14
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Knowledge and Attitudes toward Autism Spectrum Disorder in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063648. [PMID: 35329335 PMCID: PMC8950846 DOI: 10.3390/ijerph19063648] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/12/2022] [Accepted: 03/17/2022] [Indexed: 11/17/2022]
Abstract
Aims: The diagnosis of autism spectrum disorder (ASD) is not easy as there is no direct test that exists to establish such a diagnosis. Increasing community and healthcare professional knowledge of the ASD spectrum is crucial because it will encourage parents of ASD children to seek screening and diagnosis from a specialist, allowing for better early detection and treatment. This study explored the knowledge of the general population in Saudi Arabia regarding ASD and assessed variables associated with an accurate understanding of ASD. Methods: A total of 769 participants were involved in this cross-sectional study, which was conducted in Saudi Arabia between November 2021 and February 2022 using an online survey tool to explore the knowledge of the general population in Saudi Arabia regarding typical child development and ASD. A binary logistic regression analysis was used to determine factors affecting participants’ knowledge of autism. Results: Overall, the study participants showed a weak level of knowledge about autism with a mean score of 5.9 (SD: 3.1), comprising 34.7% of the total maximum obtainable score. Participants with a middle income category of 5000–7500 SR are less likely to be knowledgeable about autism compared to others (OR: 0.60 (95% CI: 0.39–0.92)) (p-value = 0.020). Conclusion: The participants in our study showed limited knowledge about autism. Government funds should be made available to facilitate educational services for ASD children. More funding and resources should be allocated by the government to provide assistance for children with special needs, and changes in public facilities are required to meet the demands of ASD patients. Through an informed educational effort, various media platforms should assist in improving the community’s understanding of ASD and their attitude toward ASD patients. Educational campaigns should focus on enhancing the public’s knowledge about ASD treatment and etiology.
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McKernan EP, Kumar M, Di Martino A, Shulman L, Kolevzon A, Lord C, Narayanan S, Kim SH. Intra-topic latency as an automated behavioral marker of treatment response in autism spectrum disorder. Sci Rep 2022; 12:3255. [PMID: 35228613 PMCID: PMC8885715 DOI: 10.1038/s41598-022-07299-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/07/2022] [Indexed: 11/11/2022] Open
Abstract
Data science advances in behavioral signal processing and machine learning hold the promise to automatically quantify clinically meaningful behaviors that can be applied to a large amount of data. The objective of this study was to identify an automated behavioral marker of treatment response in social communication in children with autism spectrum disorder (ASD). First, using an automated computational method, we successfully derived the amount of time it took for a child with ASD and an adult social partner (N pairs = 210) to respond to each other while they were engaged in conversation bits (“latency”) using recordings of brief, natural social interactions. Then, we measured changes in latency at pre- and post-interventions. Children with ASD who were receiving interventions showed significantly larger reduction in latency compared to those who were not receiving interventions. There was also a significant group difference in the changes in latency for adult social partners. Results suggest that the automated measure of latency derived from natural social interactions is a scalable and objective method to quantify treatment response in children with ASD.
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Agostini JMG, Freitas LC. HABILIDADES SOCIAIS EDUCATIVAS DE PAIS DE CRIANÇAS COM AUTISMO: REVISÃO DE LITERATURA. PSICOLOGIA ESCOLAR E EDUCACIONAL 2022. [DOI: 10.1590/2175-35392022234495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO Trata-se de uma revisão de literatura de artigos sobre habilidades sociais educativas de pais de crianças com Transtorno do Espectro Autista (TEA). Objetivos: identificar, selecionar e descrever artigos que caracterizaram Habilidades Sociais Educativas (HSE) parentais e realizar uma análise de correspondência entre os comportamentos abordados nesses estudos e o Sistema de Habilidades Sociais Educativas (SHSE) de Del Prette e Del Prette. Fonte de dados: artigos publicados no LILACS, Scielo, PubMed, ScienceDirect e PsycoINFO, sem especificação de período. Conclusões: Verificou-se a ausência de estudos no contexto brasileiro. Nove artigos em língua inglesa foram encontrados. Todas as classes de habilidades do SHSE foram identificadas, tendo sido mais frequentes as classes Monitorar Positivamente e Transmitir ou expor conteúdos sobre habilidades sociais. A análise de correspondência demonstrou a possibilidade de uso do SHSE em estudos com pais de crianças com TEA, bem como a necessidade de aprimoramentos, incluindo comportamentos avaliados e/ou treinados nessa população.
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Agostini JMG, Freitas LC. SOCIAL EDUCATIONAL SKILLS OF PARENTS OF CHILDREN WITH AUTISM: LITERATURE REVIEW. PSICOLOGIA ESCOLAR E EDUCACIONAL 2022. [DOI: 10.1590/2175-35392022234495t] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT This is a literature review of articles about educational social skills of parents of children with Autism Spectrum Disorder (ASD). Objectives: to identify, select and describe articles that characterized parental Social Educational Skills (SES) and perform a correspondence analysis between the behaviors addressed in these studies and the Social Educational Skills System (SESS) by Del Prette and Del Prette. Data source: articles published in LILACS, Scielo, PubMed, ScienceDirect and PsycoINFO, without period specification. Conclusions: There was a lack of studies in the Brazilian context. Nine English-language articles were found. All SESS skill classes were identified, with the most frequent classes Positively Monitor and Transmit or expose content about social skills. Correspondence analysis demonstrated the possibility of using the SESS in studies with parents of children with ASD, as well as the need for improvements, including behaviors evaluated and/or trained in this population.
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18
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King G, Keenan S. Solution-Focused Coaching for Friendship in Pediatric Rehabilitation: A Case Study of Goal Attainment, Client Engagement, and Coach Stances. Phys Occup Ther Pediatr 2022; 42:154-171. [PMID: 34266361 DOI: 10.1080/01942638.2021.1947435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIMS To examine goal attainment, engagement, and the stances used by coaches providing a solution-focused coaching intervention (SFC-peds) for young people with cerebral palsy pursuing friendship goals. METHODS The case study involved two clients with cerebral palsy (a young child and his mother, and a youth) and their service providers. An interpretive descriptive approach was used to analyze quantitative and qualitative data. Friendship goal attainment was assessed by the Canadian Occupational Performance Measure and goal attainment scaling, and client engagement was assessed using the Pediatric Rehabilitation Intervention Measure of Engagement-Service Provider version. Information from post-intervention client interviews was used to identify coach stances and relationships with client engagement. RESULTS Participants met their friendship goals and were considered to be highly engaged by their coaches. Four coach stances were identified: Respectful Inquiry, a Strengths Presupposition, Implementation Curiosity, and Inspiring Commitment. These stances, and aligned tactics, engaged clients on affective, cognitive, and behavioral levels, and impacted the client's stance toward their goal. CONCLUSIONS SFC-peds appears to be an effective and engaging approach for young people with disabilities working on friendship goals. The findings illustrate how the coach's stances and tactics engage clients, thus impacting the client's own stances toward change.
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Affiliation(s)
- Gillian King
- Bloorview Research Institute and Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Sarah Keenan
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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19
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Darling SJ, Goods M, Ryan NP, Chisholm AK, Haebich K, Payne JM. Behavioral Intervention for Social Challenges in Children and Adolescents: A Systematic Review and Meta-analysis. JAMA Pediatr 2021; 175:e213982. [PMID: 34661613 PMCID: PMC8524357 DOI: 10.1001/jamapediatrics.2021.3982] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/20/2021] [Indexed: 11/14/2022]
Abstract
Importance Social deficits are a common and disabling feature of many pediatric disorders; however, whether behavioral interventions are associated with benefits for children and adolescents with social deficits is poorly understood. Objective To assess whether behavioral interventions in children and adolescents with neurodevelopmental or mental health disorders are associated with improvements in social function and social cognition, and whether patient, intervention, and methodological characteristics moderate the association. Data Sources For this systematic review and meta-analysis, the PsycINFO, MEDLINE, and PubMed electronic databases were searched in December 2020 for randomized clinical trials published from database inception to December 1, 2020, including terms related to neurodevelopmental or mental health disorders, social behavior, randomized clinical trials, and children and adolescents. Data were analyzed in January 2021. Study Selection Randomized clinical trials that enrolled participants aged 4 to 17 years with social deficits and examined the efficacy of a clinician-administered behavioral intervention targeting social functioning or social cognition were included. A total of 9314 records were identified, 78 full texts were assessed for eligibility, and 33 articles were included in the study; 31 of these reported social function outcomes and 12 reported social cognition outcomes. Data Extraction and Synthesis Articles were reviewed using the Cochrane Risk of Bias Assessment for randomized clinical trials. Data were independently extracted and pooled using a weighted random-effects model. Main Outcomes and Measures The main outcome was the association of behavioral intervention with social function and social cognition. Hedges g was used to measure the standardized mean difference between intervention and control groups. Standardized effect sizes were calculated for the intervention group vs the comparison group for each trial. Results A total of 31 trials including 2131 participants (1711 [80%] male; 420 [20%] female; mean [SD] age, 10.8 [2.2] years) with neurodevelopmental or mental health disorders (autism spectrum disorder [ASD] [n = 23], attention-deficit/hyperactivity disorder [n = 4], other conditions associated with social deficits [n = 4]) were analyzed to examine differences in social function between the intervention and control groups. Significantly greater gains in social function were found among participants who received an intervention than among the control groups (Hedges g, 0.61; 95% CI, 0.40-0.83; P < .001). The type of control condition (wait list vs active control vs treatment as usual) was a significant moderator of effect size (Q2, 7.11; P = .03). Twelve studies including 487 individuals with ASD (48 [10%] female; 439 [90%] male; mean [SD] age, 10.4 [1.7] years) were analyzed to examine differences in social cognition between intervention and control groups. The overall mean weighted effect was significant (Hedges g, 0.67; 95% CI, 0.39-0.96; P < .001), indicating the treatment groups had better performance on social cognitive tasks. Conclusions and Relevance In this systematic review and meta-analysis, significantly greater gains in social function and social cognition were reported among children and adolescents who received behavioral interventions for social deficits compared with participants receiving the control conditions. These findings suggest that children and adolescents with social deficits might benefit from social skills training regardless of their specific neurodevelopmental or mental health diagnosis.
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Affiliation(s)
- Simone J. Darling
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Marquelle Goods
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Nicholas P. Ryan
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
- Department of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Anita K. Chisholm
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Kristina Haebich
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Jonathan M. Payne
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
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Yamada M, Sekine M, Tatsuse T. Pathological gaming and its association with lifestyle, irritability, and school and family environments among Japanese elementary school children. J Epidemiol 2021. [PMID: 34744101 DOI: 10.2188/jea.je20210365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Pathological gaming (PG) has emerged as one of the major public health concerns worldwide. We aimed to assess PG and its associated factors among elementary school children in Japan. METHODS We conducted a school-based observational study in Toyama, Japan in 2018. Totally, 13,413 children in the 4th-6th grades (mean age, 10.5 years) participated in the study. We distributed questionnaires and inquired about their lifestyle, irritability, and school and family environments. Referring to criteria of gaming disorder in the International Statistical Classification of Disease (ICD-11), we asked about three core symptoms: impaired control over gaming, increasing priority given to gaming over other activities, and continuation of gaming despite the negative consequences. Children who had all three criteria in the questionnaire were defined as PG. RESULTS The response rate was 97.6% and 11,826 children were included in our analyses (88.2%). The prevalence of PG was 5.6% (7.8% in boys, 3.2% in girls). Besides sex, PG was significantly associated with lifestyles including skipping breakfast (odds ratio, OR=1.33; 95% confidence interval, CI: 1.05-1.68), physical inactivity (OR=2.23; 95% CI: 1.63-3.05 for rare), late bed time (OR=2.52; 95% CI: 1.96-3.25 for ≥11 p.m), frequent irritability (OR=1.89; 95% CI: 1.47-2.43), frequent feeling of school avoidance (OR=1.92; 95% CI: 1.49-2.46), fewer close friends (OR=1.30; 95% CI: 1.08-1.56 for some), low academic performance (OR=1.53; 95% CI: 1.13-2.08), no child-parental interaction (OR=1.34; 95% CI: 1.02-1.75), and no rules at home (OR=1.21; 95% CI: 1.02-1.43). CONCLUSION Unhealthy lifestyles, irritability, and low functioning in school and family environments were associated with PG. Besides having a healthy lifestyle, parental involvement appears to be an essential countermeasure for PG in children.
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Affiliation(s)
- Masaaki Yamada
- Department of Epidemiology and Health Policy, School of Medicine, University of Toyama
| | - Michikazu Sekine
- Department of Epidemiology and Health Policy, School of Medicine, University of Toyama
| | - Takashi Tatsuse
- Department of Epidemiology and Health Policy, School of Medicine, University of Toyama
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Nuske HJ, Shih WI, Sparapani N, Baczewski L, Dimachkie Nunnally A, Hochheimer S, Garcia C, Castellon F, Levato L, Fischer E, Atkinson-Diaz ZL, Li J, Mandell DS, Kasari C. Self-regulation predicts companionship in children with autism. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 68:889-899. [PMID: 36568619 PMCID: PMC9788710 DOI: 10.1080/20473869.2021.1917109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 06/17/2023]
Abstract
Self-regulation is associated with many positive outcomes in children with and without autism, including increased mental health and academic achievement, and decreased problem behavior. Less is known regarding whether and how self-regulation and symptoms of mental health challenges (internalizing and externalizing problems) relate to social outcomes, such as friendship quality and loneliness. Parents and teachers of 106 children with autism aged 5-12 reported on children's self-regulation difficulties and externalizing and internalizing symptoms. Four-to-five months later, children reported on the quality of their friendship with their best friend (companionship, conflict, helpfulness, sense of relationship security, closeness), and their feelings of loneliness. Linear regression was used to examine the effects of self-regulation and symptoms of mental health challenges on friendship quality and loneliness. Less self-regulation difficulties predicted stronger companionship and girls had better quality friendships with their best friend than did boys, in terms of companionship, helpfulness, security and closeness, confirming that they have a protective advantage in friendship development. Autism symptoms, IQ, and age were not associated with friendship quality or loneliness. Results highlight the importance of self-regulation and mental health interventions for school-aged children with autism.
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Affiliation(s)
- Heather J. Nuske
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Wendy I. Shih
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Nicole Sparapani
- University of California Davis MIND Institute, University of California, Davis, CA, USA
| | - Lauren Baczewski
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | | | - Samantha Hochheimer
- Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Consuelo Garcia
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Fernanda Castellon
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Lynne Levato
- Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Erin Fischer
- Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Jennica Li
- University of California Davis MIND Institute, University of California, Davis, CA, USA
| | - David S. Mandell
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Connie Kasari
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
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22
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Brooks R, Lambert C, Coulthard L, Pennington L, Kolehmainen N. Social participation to support good mental health in neurodisability. Child Care Health Dev 2021; 47:675-684. [PMID: 33942905 DOI: 10.1111/cch.12876] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/10/2021] [Accepted: 04/24/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND Young people with neurodisability experience lower levels of mental wellbeing and are at increased risk of mental illness compared with their non-disabled peers. Social participation is recognized as a protective factor against mental illness and a potential pathway to support better mental wellbeing in neurodisability. METHOD This co-design study involved young people, parents and clinicians. First, possible interventions were identified through a rapid systematic evidence review. Any study designs were considered, which included people with a neurodisability aged 0-18 years, which evaluated a therapy intervention with social participation and mental health outcomes. Titles and abstracts were screened by two reviewers, from the included studies data were extracted and then presented using written summaries. Second, the summaries were discussed and prioritized in stakeholder groups with young people, parents and clinicians. Groups were audio recorded and framework analysis was used to identify and specify intervention elements and their delivery. RESULTS The evidence review identified 13,870 records, from which 43 were included. These records were published 1994-2017 and reported studies with 4-249 participants aged 16 months-18 years with a range of neurodisabilities. Five intervention approaches (social skills training, arts, sports, technology and play) were identified from the review. Two themes emerged from the stakeholder groups: intervention in the real world, feeling judged and feeling safe. The groups prioritized an intervention in real-world social leisure contexts (i.e. existing clubs and groups) using nine key intervention elements (e.g. feedback and positive verbal reinforcement) delivered by club leaders trained by healthcare professionals using five intervention procedures (e.g. a manual and video training). CONCLUSION This study has identified core elements of social participation interventions that may improve mental health outcomes in young people with neurodisability, which should now be tested.
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Affiliation(s)
- Rob Brooks
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UK
| | - Charlotte Lambert
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UK
| | - Laura Coulthard
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UK
| | - Lindsay Pennington
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Niina Kolehmainen
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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23
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Okajima J, Kato N, Nakamura M, Otani R, Yamamoto J, Sakuta R. A pilot study of combining social skills training and parenting training for children with autism spectrum disorders and their parents in Japan. Brain Dev 2021; 43:815-825. [PMID: 34023190 DOI: 10.1016/j.braindev.2021.04.007] [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] [Received: 01/27/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
The purpose of this study is to investigate the effects of a program containing a combination of social skills training (SST) and parenting training (PT) for the enrichment of social interaction skills and reduction of parenting stress for children with high-functioning autism spectrum disorder (HFASD) and their parents in Japan. Twenty-two patients with HFASD from second to fourth grade and their parents were assigned to a training group (TG) or treatment as usual (TAU) and compared. The children with HFASD and their parents who were assigned to the TG participated in the manualized program for over a period of five to six months. Subjects provided demographic and medical information and completed teacher and parent-rating scales for social competence (Social Responsiveness Scale-2: SRS-2) and parent-rating of parenting stress (Parental Stress Index: PSI) and mental health (General Health Questionnaire-28: GHQ-28). The participants exhibited some improvements pre-, middle-, and post-treatment, particularly regarding the GHQ, PSI and SRS-2, as reported by parents. However, the social skills improvement reported by teachers was not significant. At the three-month follow-up, parent-rated GHQ and PSI maintained improvement, and SRS-2 achieved the greatest improvement from the baseline rating. Although some findings indicate that a program combination of SST and PT might be useful for enhancing social skills and improving parental stress and mental health, some subscales did not show a sufficient effect. Future research should consider program contents and provide longitudinal follow-up data to test the durability of the treatment.
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Affiliation(s)
- Junko Okajima
- Department of Psychology, Rikkyo University, Japan; University of Tokyo Health Sciences, Japan.
| | - Noriko Kato
- Department of Neuropsychiatry, Keio University School of Medicine, Japan
| | | | - Ryoko Otani
- Child Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical Center, Japan
| | | | - Ryoichi Sakuta
- Child Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical Center, Japan
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24
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Tripathi I, Estabillo JA, Moody CT, Laugeson EA. Long-Term Treatment Outcomes of PEERS ® for Preschoolers: A Parent-Mediated Social Skills Training Program for Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:2610-2626. [PMID: 34302574 PMCID: PMC9114088 DOI: 10.1007/s10803-021-05147-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 12/02/2022]
Abstract
Although parent-assisted social skills interventions may reduce early social challenges in preschool-aged children with autism spectrum disorder (ASD), limited research has explored whether intervention gains maintain several years after treatment. This study examined the durability of PEERS® for Preschoolers, a parent-mediated social skills training program for preschool-aged children with ASD and other social challenges. Twenty-nine parents reported on child and family outcomes 1–5 years following treatment. Results demonstrated maintenance of treatment gains on measures of ASD-related social impairments including social communication, social responsiveness, social motivation, and peer engagement. Post-treatment improvements in problem behaviors and parenting stress were not maintained at long-term follow-up. Implications of these results are discussed.
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Affiliation(s)
- Isita Tripathi
- Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA. .,Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
| | - Jasper A Estabillo
- Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA.,Department of Psychology, University of California, 1264 Franz Hall, Los Angeles, CA, 90095-1759, USA
| | - Christine T Moody
- Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA
| | - Elizabeth A Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA
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25
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Hickin N, Käll A, Shafran R, Sutcliffe S, Manzotti G, Langan D. The effectiveness of psychological interventions for loneliness: A systematic review and meta-analysis. Clin Psychol Rev 2021; 88:102066. [PMID: 34339939 DOI: 10.1016/j.cpr.2021.102066] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/26/2021] [Accepted: 06/29/2021] [Indexed: 12/12/2022]
Abstract
Chronic loneliness is associated with a range of mental health difficulties. Previous theory and research indicate that psychological interventions show promise for reducing loneliness, however, there have been no systematic reviews or meta-analyses to ascertain the efficacy of these interventions across the lifespan. The aim of this study was to synthesise, meta-analyse and explore the heterogeneity in RCTs of psychological interventions for loneliness in order to establish their efficacy. Five databases (Ovid Embase, Ovid Medline, PsycINFO, Web of Science and CINAHL) were systematically searched in order to identify relevant studies. Included studies were required to be peer-reviewed RCTs examining psychological interventions for loneliness. Two independent coders examined the abstracts of the 3973 studies and 103 full texts, finding 31 studies that met inclusion criteria, 28 of which contained sufficient statistical information to be included in the meta-analysis. The quality of included studies was assessed using the Cochrane Risk of Bias Tool. The 31 studies (N = 3959) that were included in the systematic review were conducted with participants from a diverse range of cultures, age groups and populations. The interventions were of mixed quality and were mostly face to face, group-based and delivered weekly. The most common type of intervention was Cognitive Behavioural Therapy (CBT). 28 studies (N = 3039) were included in a meta-analysis which found that psychological interventions significantly reduced loneliness compared to control groups, yielding a small to medium effect size (g = 0.43). Subgroup analysis and meta-regressions were conducted in order to explore heterogeneity and found that type of psychological intervention was approaching significance as a moderator of the effectiveness of psychological interventions for loneliness. In conclusion, psychological interventions for loneliness across the lifespan are effective. This finding should inform policy makers, researchers and clinicians going forward, especially in the context of increased loneliness due to the COVID-19 pandemic. There was considerable heterogeneity in the effectiveness of the interventions, suggesting that future research should also explore what works for whom and consider personalising psychological treatment.
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Affiliation(s)
- Nisha Hickin
- Department of Psychology, Royal Holloway, University of London, Egham, UK.
| | - Anton Käll
- Division of Psychology, Linköping University, 581 83 Linköping, Sweden
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK
| | - Sebastian Sutcliffe
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK
| | - Grazia Manzotti
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK
| | - Dean Langan
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK
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26
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Diendorfer T, Seidl L, Mitic M, Mittmann G, Woodcock K, Schrank B. Determinants of social connectedness in children and early adolescents with mental disorder: A systematic literature review. DEVELOPMENTAL REVIEW 2021. [DOI: 10.1016/j.dr.2021.100960] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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27
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Wang X, Zhao J, Huang S, Chen S, Zhou T, Li Q, Luo X, Hao Y. Cognitive Behavioral Therapy for Autism Spectrum Disorders: A Systematic Review. Pediatrics 2021; 147:peds.2020-049880. [PMID: 33888566 DOI: 10.1542/peds.2020-049880] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
CONTEXT In several studies, authors have reported on cognitive behavioral therapy (CBT) for children and adolescents with autism spectrum disorders (ASDs), but inconsistent treatment effectiveness was revealed from these studies. OBJECTIVE To evaluate the effectiveness of CBT on the symptoms of ASD and social-emotional problems in children or adolescents with ASD by using a meta-analytic approach. DATA SOURCES Data sources included PubMed, Embase, and the Cochrane Library. STUDY SELECTION We selected randomized controlled trials (RCTs) in which authors reported effectiveness of CBT on the symptoms of ASD and social-emotional problems in children or adolescents with ASD from database inception to May 2019. DATA EXTRACTION For each study, 2 authors extracted data on the first author's surname, publication year, country, sample size, mean age, CBT target, intervention, outcome measurement, follow-up duration, and investigated outcomes. RESULTS Forty-five RCTs and 6 quasi RCTs of 2485 children and adolescents with ASDs were selected for the final meta-analysis. There was no significant difference between CBT and control for symptoms related to ASD based on self-reported outcomes (standard mean difference: -0.09; 95% confidence interval: -0.42 to 0.24; P = .593), whereas CBT significantly improved the symptoms related to ASD based on informant-reported outcomes, clinician-rated outcomes, and task-based outcomes. Moreover, the pooled standard mean differences indicated that CBT has no significant effect on symptoms of social-emotional problems based on self-reported outcomes. LIMITATIONS The quality of included studies was low to modest, significant heterogeneity among the included studies for all investigated outcomes was detected, and publication bias was inevitable. CONCLUSIONS These findings indicate that CBT may significantly improve the symptoms of ASD and social-emotional problems in children or adolescents with ASD.
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28
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Eccles AM, Qualter P. Review: Alleviating loneliness in young people - a meta-analysis of interventions. Child Adolesc Ment Health 2021; 26:17-33. [PMID: 32406165 DOI: 10.1111/camh.12389] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Loneliness is common among youth and is associated with poor physical and mental health, and poor educational outcomes. To date, there have been no meta-analyses of interventions aimed at reducing loneliness among young people. METHODS We conducted meta-analyses of single group and randomised control trials (RCTs) of studies published between 1980 and 2019, which measured loneliness as an outcome in youth ages 25 years or younger. Moderators, including sample demographics and intervention characteristics, that might affect intervention success, were examined. RESULTS A total of 39 studies (14 single group and 25 RCTs) were included, and we found evidence that youth loneliness could be reduced via intervention. Moderator analysis - including intervention characteristics, study quality and sample demographics - was also examined. CONCLUSIONS While interventions were shown to reduce loneliness among youth, the interventions included in the meta-analyses often targeted youth viewed to be at risk - for example those with health concerns - and rarely did the interventions target youth who reported loneliness. There is also no indication of whether youth experienced chronic or transient loneliness. In future work, interventions should be designed specifically for loneliness, with universal programmes helping youth manage their transient feelings of loneliness, and targeted interventions for those suffering from chronic loneliness. There is also a need to look at socioeconomic and other risk factors outside the individual for targeted interventions. KEY PRACTITIONER MESSAGE There have been no meta-analyses that have evaluated the effect of interventions for reducing loneliness among children and adolescents. We found intervention programmes targeted at youth are successful at reducing loneliness. Future interventions should be designed specially with loneliness in mind, with (a) universal programmes to help youth manage their experiences of transient loneliness, and (b) targeted interventions for youth reporting chronic loneliness. They should also examine the longer-term outcomes of the interventions. Future interventions should be designed, evaluated and then documented using guidelines on how to write up an intervention evaluation.
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Affiliation(s)
- Alice M Eccles
- Department of Psychology, University of Central Lancashire, Preston, UK.,Manchester Institute of Education, University of Manchester, Manchester, UK
| | - Pamela Qualter
- Manchester Institute of Education, University of Manchester, Manchester, UK
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29
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Wood JJ, Wood KS, Cho AC, Rosenau KA, Guevara MC, Galán C, Bazzano A, Zeldin AS, Hellemann G. Modular cognitive behavioral therapy for autism-related symptoms in children: A randomized controlled trial. J Consult Clin Psychol 2021; 89:110-125. [PMID: 33705167 PMCID: PMC8284564 DOI: 10.1037/ccp0000621] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To date, no one-on-one psychotherapy protocol for elementary and middle school-aged children with autism spectrum disorder (ASD) has been found to be efficacious for treating autism-related symptoms such as failure to initiate social interactions. This study compared modular cognitive behavioral therapy (CBT) with enhanced standard community treatment (ESCT) in terms of impact on the severity of autism-related symptoms. METHOD Children with ASD (N = 107; aged 6-13 years) were randomly assigned to a treatment condition (CBT or ESCT). Both treatments provided 32 therapy sessions. The CBT condition utilized a modular design, matching specific evidence-based treatment elements to each child's clinical needs (e.g., social-communication symptoms). The ESCT condition provided social skills training and cognitive behavioral training in a structured and linear group therapy format. The primary outcome measure was independent evaluator ratings of peer engagement during school recess using a structured and validated observation system. Parents also made session-by-session ratings on personalized autism-related symptom profiles throughout treatment. RESULTS CBT outperformed ESCT on the primary outcome measure (p < .001; d = .50; 95% CI [.06, .93]) and the secondary outcome measure (p = .003; d = .87; 95% CI [.45, 1.27]). CONCLUSIONS The modular one-on-one CBT program evaluated in this study may be beneficial for reducing the severity of autism-related symptoms in some children with ASD. Further research is needed to clarify the extent of the treatment effect and the feasibility of implementation for therapists in the community. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Jeffrey J. Wood
- Department of Education, Division of Human Development and Psychology, University of California, Los Angeles
- David Geffen School of Medicine, University of California, Los Angeles
| | - Karen Sze Wood
- David Geffen School of Medicine, University of California, Los Angeles
| | - An Chuen Cho
- Department of Education, Division of Human Development and Psychology, University of California, Los Angeles
| | - Kashia A. Rosenau
- Department of Education, Division of Human Development and Psychology, University of California, Los Angeles
| | | | | | - Alicia Bazzano
- David Geffen School of Medicine, University of California, Los Angeles
| | | | - Gerhard Hellemann
- David Geffen School of Medicine, University of California, Los Angeles
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30
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Randomized Controlled Trial of a Video Gaming-Based Social Skills Program for Children on the Autism Spectrum. J Autism Dev Disord 2021; 51:3637-3650. [PMID: 33389304 PMCID: PMC7778851 DOI: 10.1007/s10803-020-04801-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 11/21/2022]
Abstract
Families often face financial and geographical barriers to services for children with autism. The current study explored the effectiveness of a parent-supported adaptation of the computer game-based social skills program Secret Agent Society (SAS). Seventy child-parent dyads were randomized to SAS (n = 35) or a caregiver-supported cognitive skills training game (CIA—control comparison; n = 35), both completed over 10 weeks. Child participants were on the autism spectrum and aged seven to 12 years (60 boys, 10 girls). SAS participants improved more than CIA participants on parent-rated social skills and problem behaviors and teacher-rated social skills. Findings suggest the intervention may be a convenient, cost-effective therapeutic approach, especially during times of restricted face-to-face service access, such as COVID-19.
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31
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Koller D, Stoddart K. Approaches that Address Social Inclusion for Children with Disabilities: A Critical Review. CHILD & YOUTH CARE FORUM 2021. [DOI: 10.1007/s10566-020-09589-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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32
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Abstract
Social skills training programs for individuals with autism spectrum disorder are effective in improving social competence, although effects are frequently not robust across all outcomes measured. When aggregating across the social skills training programs with the strongest evidence, common elements can be identified in both the treatment delivery method and the social skills content targeted. However, social skills training programs continue to remain limited in their generalizability and scope. Existing research has primarily tested programs designed for school-aged children with autism spectrum disorder, who have average or above average intellectual functioning.
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33
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The Effectiveness of a School-Based Social Cognitive Intervention on the Social Participation of Chinese Children with Autism. J Autism Dev Disord 2020; 51:1894-1908. [DOI: 10.1007/s10803-020-04683-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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34
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Genovese A, Butler MG. Clinical Assessment, Genetics, and Treatment Approaches in Autism Spectrum Disorder (ASD). Int J Mol Sci 2020; 21:E4726. [PMID: 32630718 PMCID: PMC7369758 DOI: 10.3390/ijms21134726] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/24/2020] [Accepted: 06/27/2020] [Indexed: 12/16/2022] Open
Abstract
Autism spectrum disorder (ASD) consists of a genetically heterogenous group of neurobehavioral disorders characterized by impairment in three behavioral domains including communication, social interaction, and stereotypic repetitive behaviors. ASD affects more than 1% of children in Western societies, with diagnoses on the rise due to improved recognition, screening, clinical assessment, and diagnostic testing. We reviewed the role of genetic and metabolic factors which contribute to the causation of ASD with the use of new genetic technology. Up to 40 percent of individuals with ASD are now diagnosed with genetic syndromes or have chromosomal abnormalities including small DNA deletions or duplications, single gene conditions, or gene variants and metabolic disturbances with mitochondrial dysfunction. Although the heritability estimate for ASD is between 70 and 90%, there is a lower molecular diagnostic yield than anticipated. A likely explanation may relate to multifactorial causation with etiological heterogeneity and hundreds of genes involved with a complex interplay between inheritance and environmental factors influenced by epigenetics and capabilities to identify causative genes and their variants for ASD. Behavioral and psychiatric correlates, diagnosis and genetic evaluation with testing are discussed along with psychiatric treatment approaches and pharmacogenetics for selection of medication to treat challenging behaviors or comorbidities commonly seen in ASD. We emphasize prioritizing treatment based on targeted symptoms for individuals with ASD, as treatment will vary from patient to patient based on diagnosis, comorbidities, causation, and symptom severity.
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Affiliation(s)
| | - Merlin G. Butler
- Department of Psychiatry & Behavioral Sciences, University of Kansas Medical Center, Kansas City, KS 66160, USA;
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35
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Cahill SM, Beisbier S. Occupational Therapy Practice Guidelines for Children and Youth Ages 5-21 Years. Am J Occup Ther 2020; 74:7404397010p1-7404397010p48. [PMID: 32602457 DOI: 10.5014/ajot.2020.744001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Demand is increasing for activity- and occupation-based interventions to address occupational performance and support maximal participation of children and youth. OBJECTIVE This Practice Guideline was developed to guide decision making and support best practices in service delivery for children and youth ages 5-21 yr at home, at school, and in the community. METHOD The results from three systematic reviews (SRs) of activity- and occupation-based interventions for children and youth ages 5-21 yr were reviewed, synthesized, and translated into recommendations for education, practice, and research. RESULTS One hundred eighty-five articles were included in the three SRs examining the evidence for interventions to promote activities of daily living, instrumental activities of daily living, play and leisure, and rest and sleep; to improve mental health, positive behavior, and social participation; and to enhance learning, academic achievement, and successful participation in school. The reviews provide evidence for interventions associated with typical concerns addressed by occupational therapy practitioners. CONCLUSIONS AND RECOMMENDATIONS On the basis of the evidence, this guideline recommends that occupational therapy practitioners consistently collaborate with families and caregivers and provide services in the natural context of the desired occupation. The evidence also supports group service models and models that include peer mediation; these models can promote participation across areas of occupation. Skills-based training and therapeutic practice in the context of valued occupations are recommended over isolated sensorimotor approaches. Technology, manualized programs, and sports activities can be effective but should be evaluated and matched to age, diagnosis, and outcomes as guided by the evidence. WHAT THIS ARTICLE ADDS When guided by evidence, activity- and occupation-based interventions are effective in promoting participation and enhancing performance in valued occupations of children and youth ages 5-21 yr.
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Affiliation(s)
- Susan M Cahill
- Susan M. Cahill, PhD, OTR/L, FAOTA, is Associate Professor and Occupational Therapy Department Chair, MSOT Program, Lewis University, Romeoville, IL
| | - Stephanie Beisbier
- Stephanie Beisbier, OTD, OTR/L, is Associate Professor, Occupational Therapy Department, Mount Mary University, Milwaukee, WI;
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36
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Cahill SM, Egan BE, Seber J. Activity- and Occupation-Based Interventions to Support Mental Health, Positive Behavior, and Social Participation for Children and Youth: A Systematic Review. Am J Occup Ther 2020; 74:7402180020p1-7402180020p28. [PMID: 32204773 DOI: 10.5014/ajot.2020.038687] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Children and youth are often challenged to maintain well-being, positive behavior, and social participation. OBJECTIVE To identify evidence for occupational therapy interventions for children and youth with and at risk for mental health concerns. DATA SOURCES Articles published in English-language peer-reviewed journals between January 2010 and March 2017 identified through searches of MEDLINE, PsycINFO, CINAHL, ERIC, OTseeker, and Cochrane databases. Study Selection and Data Collectio : The methodology in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used to complete the review. Of 5,310 articles screened by title and abstract, 357 were retrieved for full-text review, and 62 met inclusion criteria. Articles describing interventions that were activity or occupation based were included. Conference proceedings, non-peer reviewed publications, dissertations, theses, and presentations were excluded. FINDINGS Of the 62 studies included in the review, 20 (32%) were Level I studies, 22 (36%) were Level II studies, and 20 (32%) were Level III studies. Articles were categorized by type: outdoor camps, video and computer games, productive occupations and life skills, meditation, animal-assisted interventions, creative arts, play, sports, and yoga. Moderate to strong evidence supports the use of yoga and sports. Moderate-strength evidence supports the use of play and creative arts. Evidence for the use of animal-assisted interventions, meditation, video and computer games, and productive occupations was of low strength. CONCLUSION AND RELEVANCE Substantial evidence exists to support the use of activity- and occupation-based interventions to address the mental health, behavioral, and social participation concerns of children and youth. Occupational therapy practitioners should match the desired outcome of therapy with the appropriate intervention to provide the best and most effective services to their clients. WHAT THIS ARTICLE ADDS This review provides additional support for the use of activity- and occupation-based interventions (i.e., those that involve active participation) to improve the behavior, social participation, and mental health of children and youth.
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Affiliation(s)
- Susan M Cahill
- Susan M. Cahill, PhD, OTR/L, FAOTA, is Associate Professor and Occupational Therapy Department Chair, MSOT Program, Lewis University, Romeoville, IL;
| | - Brad E Egan
- Brad E. Egan, OTD, PhD, CADC, OTR/L, is Associate Professor and Occupational Therapy Program Site Coordinator, Occupational Therapy Program, Lenoir-Rhyne University, Columbia, SC
| | - Joanna Seber
- Joanna Seber, OTD, OTR/L, is Adjunct Instructor, MSOT Program, Lewis University, Romeoville, IL. At the time of the study, she was a postprofessional OTD student (maiden name Swanton) at the University of Illinois at Chicago
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37
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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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Raulston TJ, Bhana N, McIntyre LL, Ousley C. Brief Report: Collateral Joint Engagement During a Playdate Intervention for Children with and at Risk for Autism. J Autism Dev Disord 2020; 51:357-363. [PMID: 32468394 DOI: 10.1007/s10803-020-04544-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Joint engagement involves a child coordinating their attention between a person and a shared event. Children with autism present with impaired joint engagement. Playdates are a common way that children socially engage yet have been largely overlooked in the social skills literature. Requesting skills have been conceptualized as pivotal, producing collateral effects. In the current study, we conducted a secondary analysis of a single-case design that evaluated a parent-implemented playdate intervention focused on supporting children and peers to request and respond to one another during games. We examined the collateral effects of the playdate intervention on joint engagement. Two children demonstrated gains in joint engagement with a peer, and the third exhibited variable changes. Implications for future research are discussed.
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Affiliation(s)
- Tracy J Raulston
- Department of Educational Psychology, Counseling, and Special Education, Pennsylvania State University, University Park, PA, USA.
| | - Naima Bhana
- Department of Educational Psychology, Counseling, and Special Education, Pennsylvania State University, University Park, PA, USA
| | - Laura Lee McIntyre
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
| | - Ciara Ousley
- Department of Educational Psychology, Counseling, and Special Education, Pennsylvania State University, University Park, PA, USA
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Moody CT, Laugeson EA. Social Skills Training in Autism Spectrum Disorder Across the Lifespan. Child Adolesc Psychiatr Clin N Am 2020; 29:359-371. [PMID: 32169267 DOI: 10.1016/j.chc.2019.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Social skills training programs for individuals with autism spectrum disorder are effective in improving social competence, although effects are frequently not robust across all outcomes measured. When aggregating across the social skills training programs with the strongest evidence, common elements can be identified in both the treatment delivery method and the social skills content targeted. However, social skills training programs continue to remain limited in their generalizability and scope. Existing research has primarily tested programs designed for school-aged children with autism spectrum disorder, who have average or above average intellectual functioning.
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40
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King G, Keenan S, McDougall C, Oake M. Investigating a Participation-Based Friendship Intervention for Youth with Disabilities: Effects on Goal Attainment, Social Self-Efficacy, and Engagement. Phys Occup Ther Pediatr 2020; 40:152-167. [PMID: 31409191 DOI: 10.1080/01942638.2019.1646376] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aims: This preliminary study examined the effects of a participation-based friendship intervention for youth with physical and developmental disabilities on their goal attainment, social self-efficacy, and engagement in program sessions.Methods: Before and after the eight-session intervention, five youth with physical and developmental disabilities ages 15-20 (3 females) completed a measure of goal attainment scaling (GAS) and the Canadian Occupational Performance Measure (COPM) for goals related to friendship, along with a measure of social self-efficacy. Engagement was assessed after every second session (i.e. four times). After the program, youth completed interviews to capture their perceptions of each of these variables. Quantitative data were analyzed descriptively, enriched with the qualitative data.Results: Overall, youth achieved their GAS goals and demonstrated clinically significant change in mean COPM performance and satisfaction. Three youth displayed clinically significant change in social self-efficacy. Engagement in the program was high, with the majority of participants reporting slightly increasing levels of engagement over the sessions. The interviews substantiated these quantitative changes.Conclusions: There are few evidence-informed friendship interventions for youth with disabilities. This study provides initial evidence for the effectiveness of a participation-based friendship intervention incorporating coaching and focusing on real-world goals and contexts.
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Affiliation(s)
- Gillian King
- Bloorview Research Institute, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Sarah Keenan
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | | | - Michelle Oake
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
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41
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Shih W, Dean M, Kretzmann M, Locke J, Senturk D, Mandell DS, Smith T, Kasari C. Remaking Recess Intervention for Improving Peer Interactions at School for Children With Autism Spectrum Disorder: Multisite Randomized Trial. SCHOOL PSYCHOLOGY REVIEW 2019. [DOI: 10.17105/spr-2017-0113.v48-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Wendy Shih
- University of California, Los Angeles
- Loma Linda University, Loma Linda
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42
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Safer-Lichtenstein J, Hamilton JC, McIntyre LL. Examining Demographics in Randomized Controlled Trials of Group-Based Social Skills Interventions for Individuals with Autism Spectrum Disorder. J Autism Dev Disord 2019; 49:3453-3461. [PMID: 31119512 DOI: 10.1007/s10803-019-04063-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We reviewed the demographic reporting practices and diversity of participants in published randomized controlled trial studies of group-based social skills interventions (GSSIs) for individuals with autism spectrum disorder (ASD). A total of 17 studies met inclusionary criteria. Results of this review suggest that the majority of published RCTs reported on participant gender and race/ethnicity, with fewer studies including details on household income and caregiver education. Study samples generally lacked diversity, with an overrepresentation of participants who were male, White, and from upper-middle class backgrounds. Additionally, we found that nearly all GSSI studies focused on participants with average or high IQs, or were specifically classified as having a higher functioning sub-diagnosis within ASD. Implications and future directions for research are discussed.
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Affiliation(s)
| | - Jillian C Hamilton
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
| | - Laura Lee McIntyre
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
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43
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Gilmore R, Sakzewski L, Ziviani J, Mcintyre S, Smithers Sheedy H, Hilton N, Williams T, Quinn K, Sarandrea AM, Laugeson E, Chatfield M. Multicentre, randomised waitlist control trial investigating a parent-assisted social skills group programme for adolescents with brain injuries: protocol for the friends project. BMJ Open 2019; 9:e029587. [PMID: 31462477 PMCID: PMC6720336 DOI: 10.1136/bmjopen-2019-029587] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Adolescents with brain injury frequently have difficulties with social competence, which persist into adulthood affecting their participation in daily life. To date, there has been limited research into the efficacy of social competence interventions in this population. Research from the Program for the Education and Enrichment of Relational Skills (PEERS) has demonstrated significant improvements in social competence skills, maintained at 1-year to 5-year follow-up, for adolescents with autism spectrum disorder. PEERS has not yet been tested among adolescents with brain injury. This protocol describes a pragmatic, parallel two-group pre-test post-test randomised waitlist control trial across two sites in Australia, which aims to evaluate the feasibility, acceptability and efficacy of PEERS in adolescents with brain injury compared with usual care. METHODS AND ANALYSIS Forty adolescents with an acquired brain injury or cerebral palsy will be randomly assigned to either the 14-week PEERS group or waitlist care as usual group. The waitlist group will then receive PEERS following the 26-week retention time point. Outcomes will be assessed at baseline, 14 weeks (immediately postintervention) and 26 weeks follow-up (retention). The primary outcomes are self-report and parent report on the Social Skills Improvement System Rating Scales immediately post PEERS at 14 weeks. Secondary outcomes include increased frequency of get-togethers with peers with reduced conflict and increased adolescent self-reported knowledge of social skills. Acceptability and feasibility will be examined through qualitative analysis of focus group data collected after the completion of each group. ETHICS AND DISSEMINATION Ethics approval has been granted by the Medical Research Ethics Committee Children's Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/17/QRCH/87), The University of Queensland (2017000864) and the Cerebral Palsy Alliance Ethics Committee (20170802/HREC:EC00402). The findings will be disseminated in peer-reviewed journals, by conference presentation and newsletters to consumers. TRIAL REGISTRATION NUMBER ACTRN12617000723381.
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Affiliation(s)
- Rose Gilmore
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Sarah Mcintyre
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Queensland, Australia
| | - Hayley Smithers Sheedy
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Queensland, Australia
| | - Nicola Hilton
- Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Tracey Williams
- Kids Rehab, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Kirsten Quinn
- Youth Services Department, Cerebral Palsy Alliance, Sydney, NSW, Australia
| | - Anne Marie Sarandrea
- Kids Rehab, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Elizabeth Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California, USA
| | - Mark Chatfield
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Queensland, Australia
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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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45
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Nowell SW, Watson LR, Boyd B, Klinger LG. Efficacy Study of a Social Communication and Self-Regulation Intervention for School-Age Children With Autism Spectrum Disorder: A Randomized Controlled Trial. Lang Speech Hear Serv Sch 2019; 50:416-433. [PMID: 31287766 DOI: 10.1044/2019_lshss-18-0093] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose This study aimed to examine the initial efficacy of a parent-assisted blended intervention combining components of Structured TEACCHing and Social Thinking, designed to increase social communication and self-regulation concept knowledge in 1st and 2nd graders ( n = 17) diagnosed with autism spectrum disorder (ASD) and their parents. Method A randomized delayed treatment control group design with pre- and postintervention assessments of both parents and children was implemented within a community practice setting. Two follow-up assessments at 3 and 6 months postintervention were also completed. Results Overall, results indicate that the intervention is efficacious in teaching social communication and self-regulation concept knowledge to children with ASD and their parents. Both parents and children demonstrated an increase in social communication and self-regulation knowledge after participating in the Growing, Learning, and Living With Autism Group as compared to a delayed treatment control group. The effects of the intervention did not extend to parent-child interactions coded from video recordings. Child treatment effects were maintained at the 3- and 6-month follow-up assessments. Conclusions Preliminary efficacy of the Growing, Learning, and Living With Autism Group was established. Based on parent report at the conclusion of the intervention, this is a socially valid intervention for teaching social communication and self-regulation skills to school-age children with ASD. Supplemental Material https://doi.org/10.23641/asha.8637236.
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Affiliation(s)
- Sallie W Nowell
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill
| | - Linda R Watson
- Department of Allied Health Sciences, Division of Speech and Hearing Sciences, The University of North Carolina at Chapel Hill
| | - Brian Boyd
- Juniper Gardens Children's Project, The University of Kansas, Lawrence
| | - Laura G Klinger
- TEACCH Autism Program, The University of North Carolina at Chapel Hill
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46
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Emotion Regulation Intensive Outpatient Programming: Development, Feasibility, and Acceptability. J Autism Dev Disord 2019; 49:495-508. [PMID: 30143951 DOI: 10.1007/s10803-018-3727-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Individuals with Autism Spectrum Disorder (ASD) and/or intellectual and developmental disabilities (DD) often struggle with behavior management and emotion-regulation (ER). In this manuscript, we describe the results of a chart review examining a group treatment program designed to address ER deficits in youth with ASD and/or DD. The intensive 5 week program utilizes cognitive behavior, applied behavior analysis, and mindfulness techniques and includes biweekly child and parent groups. Results indicate that this program is feasible and associated with high caregiver satisfaction. Pre-and-post outcome results indicate statistically significant improvement on behavioral measures, but did not demonstrate significant improvment on the Pediatric Quality of Life Family Impact Module. Based on overall positive outcomes, a randomized controlled trial of the program is indicated.
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47
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Shum KKM, Cho WK, Lam LMO, Laugeson EA, Wong WS, Law LSK. Learning How to Make Friends for Chinese Adolescents with Autism Spectrum Disorder: A Randomized Controlled Trial of the Hong Kong Chinese Version of the PEERS® Intervention. J Autism Dev Disord 2019; 49:527-541. [PMID: 30143950 DOI: 10.1007/s10803-018-3728-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study examined the treatment efficacy of PEERS® (Program for the Education and Enrichment of Relational Skills) among Chinese adolescents with autism spectrum disorder (ASD) in Hong Kong. The original PEERS® manual was translated into Chinese, and cultural adjustments were made according to a survey among 209 local adolescents in the general population. 72 high-functioning adolescents with ASD were randomly assigned to a treatment or waitlist control group. The 14-week parent-assisted training significantly improved social skills knowledge and social functioning, and also reduced autistic mannerisms. Treatment outcomes were maintained for 3 months after training and replicated in the control group after delayed treatment. The present study represents one of the few randomized controlled trials on PEERS® conducted outside North America.
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Affiliation(s)
- Kathy Kar-Man Shum
- Department of Psychology, The University of Hong Kong, Pokfulam Road, Hong Kong, China.
| | - Wai Kwan Cho
- SAHK, 17/F, 21 Pak Fuk Road, North Point, Hong Kong, China
| | | | - 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
| | - Wai Shan Wong
- SAHK, 17/F, 21 Pak Fuk Road, North Point, Hong Kong, China
| | - Louisa S K Law
- SAHK, 17/F, 21 Pak Fuk Road, North Point, Hong Kong, China
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48
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Mikami AY, Miller M, Lerner MD. Social functioning in youth with attention-deficit/hyperactivity disorder and autism spectrum disorder: transdiagnostic commonalities and differences. Clin Psychol Rev 2019; 68:54-70. [PMID: 30658861 DOI: 10.1016/j.cpr.2018.12.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/12/2018] [Accepted: 12/31/2018] [Indexed: 12/21/2022]
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are both neurodevelopmental disorders originating in childhood with high associated impairments and public health significance. There has been growing recognition of the frequent co-occurrence, and potential interrelatedness, between ADHD and ASD without intellectual disability. In fact, the most recent (5th) edition of the DSM is the first to allow ADHD and ASD to be diagnosed in the same individual. The study of transdiagnostic features in ADHD and ASD is important for understanding, and treating, these commonly co-occurring disorders. Social impairment is central to the description and prognosis of both disorders, and many youth with some combination of ADHD and ASD present to clinics for social skills training interventions. However, the aspects of social functioning that are impaired may have both shared and distinct features between the two disorders, relating to some overlapping and some diverse etiologies of social problems in ADHD compared to ASD. These findings have implications for interventions to address social problems in youth with these conditions. We conclude with a discussion about areas for future research and novel intervention targets in youth with ADHD, ASD, and their comorbidity.
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Affiliation(s)
| | - Meghan Miller
- University of California Davis MIND Institute, Sacramento, CA, USA
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49
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Ameis SH, Kassee C, Corbett-Dick P, Cole L, Dadhwal S, Lai MC, Veenstra-VanderWeele J, Correll CU. Systematic review and guide to management of core and psychiatric symptoms in youth with autism. Acta Psychiatr Scand 2018; 138:379-400. [PMID: 29904907 DOI: 10.1111/acps.12918] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Evidence-based guidance of clinical decision-making for the management of Autism Spectrum Disorder (ASD) is lacking, particularly for co-occurring psychiatric symptoms. This review evaluates treatment evidence for six common symptom targets in children/adolescents with ASD and provides a resource to facilitate application of the evidence to clinical practice. METHOD A systematic search identified randomized controlled trials (RCTs) and high-quality systematic reviews published between 2007 and 2016, focused on: social interaction/communication impairment, stereotypic/repetitive behaviours, irritability/agitation, attention-deficit/hyperactivity disorder symptoms, mood or anxiety symptoms, and sleep difficulties. We then completed qualitative evaluation of high-quality systematic reviews/meta-analyses and quantitative evaluation of recently published RCTs not covered by prior comprehensive systematic reviews. RESULTS Recently published RCTs focused on social interaction and communication impairment (trials = 32) using psychosocial interventions. Interventions for irritability/agitation (trials = 16) were mainly pharmacological. Few RCTs focused on other symptom targets (trials = 2-5/target). Integration of these results with our qualitative review indicated that few established treatment modalities exist, and available evidence is limited by small studies with high risk of bias. CONCLUSION Given the current evidence-base, treatment targets must be clearly defined, and a systematic approach to intervention trials in children/adolescents with ASD must be undertaken with careful consideration of the limitations of safety/efficacy data.
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Affiliation(s)
- S H Ameis
- Child, Youth and Emerging Adult Program, Centre for Addiction and Mental Health (CAMH), Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - C Kassee
- Child, Youth and Emerging Adult Program, Centre for Addiction and Mental Health (CAMH), Campbell Family Mental Health Research Institute, Toronto, ON, Canada
| | - P Corbett-Dick
- Division of Developmental and Behavioural Pediatrics, University of Rochester School of Nursing, University of Rochester Medical Centre, Rochester, NY, USA
| | - L Cole
- Division of Developmental and Behavioural Pediatrics, University of Rochester School of Nursing, University of Rochester Medical Centre, Rochester, NY, USA
| | - S Dadhwal
- Child, Youth and Emerging Adult Program, Centre for Addiction and Mental Health (CAMH), Campbell Family Mental Health Research Institute, Toronto, ON, Canada
| | - M-C Lai
- Child, Youth and Emerging Adult Program, Centre for Addiction and Mental Health (CAMH), Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - J Veenstra-VanderWeele
- New York Presbyterian Hospital Center for Autism and the Developing Brain, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - C U Correll
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA.,Hofstra Northwell School of Medicine, Hempstead, NY, USA.,Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
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50
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Schiltz HK, McVey AJ, Dolan BK, Willar KS, Pleiss S, Karst JS, Carson AM, Caiozzo C, Vogt EM, Yund BD, Van Hecke AV. Changes in Depressive Symptoms Among Adolescents with ASD Completing the PEERS ® Social Skills Intervention. J Autism Dev Disord 2018; 48:834-843. [PMID: 29164445 PMCID: PMC10321229 DOI: 10.1007/s10803-017-3396-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Depression is a common concern among people with autism spectrum disorder (ASD) and is often associated with social skills and relationship challenges. The present data, from a randomized controlled trial, examined the effect of PEERS® on self-reported depressive symptoms via the Children's Depression Inventory (CDI) among 49 adolescents with ASD. Findings revealed that many CDI subscale scores declined (p's < 0.05) and were related to direct social contact on the Quality of Socialization Questionnaire at posttest (p's < 0.05). Exploratory analyses uncovered that suicidality was less evident following PEERS®. Findings support the notion that social functioning and depression may be intimately intertwined in ASD; therefore, bolstering social skills in ASD may positively influence other domains of functioning, including mental health.
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Affiliation(s)
- Hillary K Schiltz
- Marquette University, 604 N 16th St. Cramer Hall, Milwaukee, WI, 53233, USA.
| | - Alana J McVey
- Marquette University, 604 N 16th St. Cramer Hall, Milwaukee, WI, 53233, USA
| | - Bridget K Dolan
- Marquette University, 604 N 16th St. Cramer Hall, Milwaukee, WI, 53233, USA
| | - Kirsten S Willar
- Marquette University, 604 N 16th St. Cramer Hall, Milwaukee, WI, 53233, USA
| | - Sheryl Pleiss
- Marquette University, 604 N 16th St. Cramer Hall, Milwaukee, WI, 53233, USA
- Great Lakes Neurobehavioral Center, 7373 France Avenue South, Suite 302, Edina, MN, 55435, USA
| | - Jeffrey S Karst
- Marquette University, 604 N 16th St. Cramer Hall, Milwaukee, WI, 53233, USA
- Children's Hospital of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
| | - Audrey M Carson
- Marquette University, 604 N 16th St. Cramer Hall, Milwaukee, WI, 53233, USA
- Texas Children's Hospital, 6621 Fannin St, Houston, TX, 77030, USA
| | - Christina Caiozzo
- Marquette University, 604 N 16th St. Cramer Hall, Milwaukee, WI, 53233, USA
| | - Elisabeth M Vogt
- Marquette University, 604 N 16th St. Cramer Hall, Milwaukee, WI, 53233, USA
| | - Brianna D Yund
- University of Wisconsin, Milwaukee, 2441 E. Hartford Ave., Milwaukee, WI, 53211, USA
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