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Strelnikov J, Zdonczyk A, Pruett JR, Culican S, Tychsen L, Gordon M, Marrus N, Todorov A, Reynolds M. Social and Quality-of-Life Impact of Refractive Surgery in Children With Developmental Disorders and Spectacle Nonadherence. Am J Ophthalmol 2024; 269:20-29. [PMID: 39168367 DOI: 10.1016/j.ajo.2024.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 08/06/2024] [Accepted: 08/06/2024] [Indexed: 08/23/2024]
Abstract
PURPOSE Children with autism spectrum disorder and intellectual disability often cannot tolerate wearing spectacles or contact lenses, which are the standard-of-care for treating ametropia.1,2 We aimed to assess the impact of refractive surgery on social functioning and vision-specific quality-of-life (VSQOL) in this population. DESIGN Prospective, before-and-after case series. METHODS Setting: Single, academic tertiary care center. STUDY POPULATION 18 children with autism spectrum disorder and/or intellectual disability, ametropia, and spectacle nonadherence were included in the analysis. PROCEDURE Participants underwent refractive surgery with either intraocular lens implantation or keratectomy. Parents completed the Social Responsiveness Scale (SRS-2) and Pediatric Eye Questionnaire (PedEyeQ) at baseline and 1, 6, and 12 months postsurgery.3,4 Main outcome measures: Median change in SRS-2 T-scores and PedEyeQ scores 12 months after surgery, compared to baseline. The minimum clinically important difference was set at 5 points for the SRS-2 and 10 points for the PedEyeQ. RESULTS At 12 months after surgery, statistically significant improvements were observed in the SRS-2 domains of Social Awareness (8 points, 95% CI 2-13, P = .03) and Social Motivation (7 points, 95% CI 2-15, P = .03). Total SRS-2 T-score improved in a clinically important manner for 56% (10/18) of patients, but the median change was not statistically significant (5 points, 95% CI -1 to 9, P = .10). VSQOL showed statistically significant improvements in the domains of Functional Vision (40 points, 95% CI 7-73, P = .02) and Bothered by Eyes/Vision (23 points, 95% CI 3-45, P = .02). CONCLUSIONS Refractive surgery led to clinically and statistically significant improvements in domains of social functioning and VSQOL at 12 months after surgery. A narrow majority of patients demonstrated a clinically important improvement in overall social functioning, but these changes were not statistically significant. The results suggest that refractive surgery in children with neurodevelopmental disorders, ametropia, and spectacle nonadherence may provide developmental and quality-of-life benefits. Larger, controlled studies are required to validate these findings.
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Affiliation(s)
- Jacob Strelnikov
- From the Department of Ophthalmology & Visual Sciences (J.S., A.Z., L.T., M.G., M.R.), Washington University School of Medicine, St. Louis, Missouri, USA
| | - Alexandra Zdonczyk
- From the Department of Ophthalmology & Visual Sciences (J.S., A.Z., L.T., M.G., M.R.), Washington University School of Medicine, St. Louis, Missouri, USA
| | - John R Pruett
- Department of Psychiatry (J.R.P., N.M., A.T.), Washington University School of Medicine, St. Louis, Missouri, USA
| | - Susan Culican
- Department of Ophthalmology and Visual Neurosciences (S.C.), University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Lawrence Tychsen
- From the Department of Ophthalmology & Visual Sciences (J.S., A.Z., L.T., M.G., M.R.), Washington University School of Medicine, St. Louis, Missouri, USA
| | - Mae Gordon
- From the Department of Ophthalmology & Visual Sciences (J.S., A.Z., L.T., M.G., M.R.), Washington University School of Medicine, St. Louis, Missouri, USA
| | - Natasha Marrus
- Department of Psychiatry (J.R.P., N.M., A.T.), Washington University School of Medicine, St. Louis, Missouri, USA
| | - Alexandre Todorov
- Department of Psychiatry (J.R.P., N.M., A.T.), Washington University School of Medicine, St. Louis, Missouri, USA
| | - Margaret Reynolds
- From the Department of Ophthalmology & Visual Sciences (J.S., A.Z., L.T., M.G., M.R.), Washington University School of Medicine, St. Louis, Missouri, USA; Department of Psychiatry (J.R.P., N.M., A.T.), Washington University School of Medicine, St. Louis, Missouri, USA.
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Thompson BAD, Gilmore R, Barfoot J, Sakzewski L. A systematic review of the efficacy of group social skills interventions on social functioning and social participation in children with acquired brain injury or cerebral palsy. Child Care Health Dev 2024; 50:e13242. [PMID: 38528324 DOI: 10.1111/cch.13242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 12/15/2023] [Accepted: 02/08/2024] [Indexed: 03/27/2024]
Abstract
AIM The aim of this study was to evaluate the efficacy of Group social skills interventions (GSSIs) versus any comparator on social functioning in children aged 5-12 years with acquired brain injury or cerebral palsy. BACKGROUND GSSIs are an evidence-based approach to foster social skills development in children with autism spectrum disorder. Currently, limited literature exploring GSSIs in children with acquired brain injury and cerebral palsy is available. RESULTS MEDLINE, SCOPUS, Embase, CINAHL, Cochrane Library, PsycINFO, clinicaltrials.gov, ICTRP and ProQuest Dissertations and Theses were systematically searched. Study screening, risk-of-bias, Grading of Recommendations Assessment, Development and Evaluation and data extraction were performed in duplicate. Six studies were included in the narrative synthesis (one randomised controlled trial and five nonrandomised studies). Results indicate that GSSIs may increase children's social skills as measured on the Social Skills Rating System and Social Skills Questionnaire. Very low certainty evidence was found for improvements in social functioning and competence. CONCLUSIONS There is low certainty evidence that participation in GSSI may lead to gains in social functioning for children with acquired brain injury or cerebral palsy. Given the certainty of the evidence, these results must be interpreted with caution. Only one randomised controlled trial of GSSIs for children with acquired brain injury was identified, underscoring the need for additional high-quality studies.
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Affiliation(s)
- Bianca A D Thompson
- Child Health Research Centre, Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
| | - Rose Gilmore
- Child Health Research Centre, Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
- Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Jacqui Barfoot
- Child Health Research Centre, Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
| | - Leanne Sakzewski
- Child Health Research Centre, Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
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Antezana L, Albright J, Scarpa A, Richey JA, Laugeson EA, Factor RS. PEERS® for Preschoolers preliminary outcomes and predictors of treatment response. J Autism Dev Disord 2023; 53:4671-4684. [PMID: 36103076 PMCID: PMC10011023 DOI: 10.1007/s10803-022-05724-7] [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: 08/14/2022] [Indexed: 11/28/2022]
Abstract
PEERS® for Preschoolers (P4P) is a social skills group program for young autistic children and their caregivers, which provides everyday tools for interacting and communicating with others. Twenty-two caregiver-child dyads participated and completed pre-treatment, post-treatment, and follow-up measures (4-16 weeks after). Using single-subject analyses to examine social skills, 60% demonstrated post-treatment improvement, and 53.85% demonstrated follow-up improvement. Regarding a secondary outcome of behavioral difficulties, 33.33% demonstrated post-treatment reduction, and 7.69% demonstrated follow-up reduction. Using regressions, autistic traits predicted outcomes; fewer social communication difficulties predicted both greater social skills and fewer behavioral difficulties at post-treatment, while fewer repetitive behaviors predicted fewer post-treatment and follow-up behavioral difficulties. These results preliminarily demonstrate the benefits of P4P and how autistic traits may impact P4P outcomes.
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Affiliation(s)
- Ligia Antezana
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, 24061, Blacksburg, VA, USA.
- Virginia Tech Autism Clinic & Center for Autism Research, Virginia Tech, Blacksburg, VA, USA.
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Jordan Albright
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, 24061, Blacksburg, VA, USA
- Virginia Tech Autism Clinic & Center for Autism Research, Virginia Tech, Blacksburg, VA, USA
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Angela Scarpa
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, 24061, Blacksburg, VA, USA
- Virginia Tech Autism Clinic & Center for Autism Research, Virginia Tech, Blacksburg, VA, USA
| | - John A Richey
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, 24061, Blacksburg, VA, USA
- Virginia Tech Autism Clinic & Center for Autism Research, Virginia Tech, Blacksburg, VA, USA
| | - Elizabeth A Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Reina S Factor
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, 24061, Blacksburg, VA, USA
- Virginia Tech Autism Clinic & Center for Autism Research, Virginia Tech, Blacksburg, VA, USA
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
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Bierman KL, Welsh JA, Hall CM, Jacobson LN, Lee DL, Jones DE. Efficacy of the Fast Track Friendship Group Program for Peer-rejected Children: A Randomized-Controlled Trial. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:763-779. [PMID: 35427193 DOI: 10.1080/15374416.2022.2051523] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate the benefits of the Fast Track Friendship Group program implemented as a stand-alone school-based intervention on the social cognitions, social behavior, peer and teacher relationships of peer-rejected students. METHOD Over four successive years, 224 peer-rejected elementary students (57% White, 17% Black, 20% Latinx, 5% multiracial; 68% male; grades 1-4; Mage = 8.1 years old) were identified using peer sociometric nominations and randomly assigned to the intervention (n = 110) or a treatment-as-usual control group (n = 114). Four school districts serving economically-disadvantaged urban and rural communities participated. Intervention involved weekly small group social skills training with classmate partners, with sessions tailored to address individual child needs. Consultation meetings held at the start and mid-point of intervention were designed to help teachers and parents support the generalization of targeted skills. RESULTS Multi-level linear models, with children nested within schools (controlling for demographics and baseline scores) documented improvements in social-cognitive skills (direct assessments of emotion recognition and competent social problem-solving), social behavior (teacher ratings of social skills and externalizing behavior), and interpersonal relationships (peer sociometric nominations of peer acceptance and friendships, teacher-rated student-teacher closeness). Significant effects were generally small (ds = .19-.36) but consistent across child sex, grade level, and behavioral characteristics. CONCLUSIONS The intervention proved feasible for high-fidelity implementation in school settings and produced significant improvements in the social adjustment of peer-rejected children, validating the approach as a school-based Tier 2 intervention.
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Affiliation(s)
- Karen L Bierman
- Child Study Center, Department of Psychology, The Pennsylvania State University
| | - Janet A Welsh
- Edna Bennett Pierce Prevention Research Center, The Pennsylania State University
| | - Cristin M Hall
- Department of Educational Psychology, Counseling, and Special Education, The Pennsylvania State University
| | - Linda N Jacobson
- Child Study Center, Department of Psychology, The Pennsylvania State University
| | - David L Lee
- Department of Educational Psychology, Counseling, and Special Education, The Pennsylvania State University
| | - Damon E Jones
- Edna Bennett Pierce Prevention Research Center, The Pennsylania State University
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Lodewyk K, Bagnell A, Courtney DB, Newton AS. Review: Adverse event monitoring and reporting in studies of pediatric psychosocial interventions: a systematic review. Child Adolesc Ment Health 2023. [PMID: 37463769 DOI: 10.1111/camh.12661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Adverse event monitoring in studies of psychotherapy is crucial to clinical decision-making, particularly for weighing of benefits and harms of treatment approaches. In this systematic review, we identified how adverse events are defined, measured, and reported in studies of psychosocial interventions for children with mental disorders. METHOD Medline, PsycINFO, Embase, ProQuest Dissertations and Theses Global, and the Cochrane Library were searched from January 2011-January 2023, and Google Scholar from January 2011-February 2023. English language experimental and quasi-experimental studies that evaluated the efficacy or effectiveness of psychosocial interventions for childhood mental disorders were included. Information on the definition, assessment, and report of adverse events was extracted using a checklist based on Good Clinical Practice guidelines. RESULTS In this review, 117 studies were included. Studies most commonly involved treating anxiety disorders or obsessive-compulsive disorder (32/117; 27%); 44% of the experimental interventions tested (52/117) were cognitive behavioral therapies. Adverse events were monitored in 36 studies (36/117; 31%) with a protocol used in 19 of these studies to guide monitoring (19/36; 53%). Twenty-seven different events were monitored across the studies with hospitalization the most frequently monitored (3/36; 8%). Event severity was fully assessed in 6 studies (17%) and partially assessed in 12 studies (33%). Only 4/36 studies (11%) included assessing events for cause. CONCLUSIONS To date, adverse events have been inconsistently defined, measured and reported in psychosocial intervention studies of childhood mental health disorders. Information on adverse events is an essential knowledge component for understanding the potential impacts and risks of therapeutic interventions.
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Affiliation(s)
| | | | - Darren B Courtney
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Fatehi M, Fatehi L, Mowbray O. Autism spectrum disorder, parent coping, and parent concerns during the COVID-19 pandemic. CHILDREN AND YOUTH SERVICES REVIEW 2023; 149:106923. [PMID: 36960037 PMCID: PMC10019039 DOI: 10.1016/j.childyouth.2023.106923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 outbreak beginning in 2019 has created a challenging period for families who have children with autism spectrum disorder (ASD). The purpose of this study was to examine parents' perceptions about the consequences of the pandemic on their child who has ASD and parents' concerns and resources during the pandemic. Data was collected between July to November 2020 from U.S. parents who have at least one child with ASD between 3 and 21 years old. An online survey, consisting of 88 items, was developed and distributed online in newsletters and Twitter pages of several ASD organizations, and various caregiving support groups on Facebook. Descriptive analysis showed that during the data collection time (N = 57), 79% of the children had immediate access to electronic devices to utilize online services. Many of the children used remote learning services for less than 2 h (74%) per day. Many children had difficulties following social distance rules. They spent more time in passive activities than active activities. Twenty-five percent of parents reported that they drank alcohol more often during the pandemic. However, parents who participated in support groups consumed less alcohol. Also, child symptom severity was associated with parents taking less times for themselves. These results can assist practitioners in identifying specific difficulties that parents and children with ASD experienced during the pandemic. This work also underlines the parents' needs for community supports and mental health services.
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Affiliation(s)
- Mariam Fatehi
- University of Georgia, School of Social Work, United States
| | - Leila Fatehi
- University of Georgia, School of Social Work, United States
| | - Orion Mowbray
- University of Georgia, School of Social Work, United States
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Chancel R, Miot S, Dellapiazza F, Baghdadli A. Group-based educational interventions in adolescents and young adults with ASD without ID: a systematic review focusing on the transition to adulthood. Eur Child Adolesc Psychiatry 2022; 31:1-21. [PMID: 32889578 DOI: 10.1007/s00787-020-01609-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/20/2020] [Indexed: 12/13/2022]
Abstract
There is a growing number of young people, diagnosed with an autism-spectrum disorder (ASD), transitioning to adulthood. Among this number, individuals without an intellectual disability have significant adaptive deficits and need individualized care and support services to better target vocational, social, and educational prospects and outcomes. Group-based interventions, including patient education, social-skills training, and cognitive-behavioral therapy, are widely used in clinical settings to improve the daily life and prospects of ASD individuals facing the challenge of transitioning to adulthood. We performed a systematic review of studies concerning the efficiency of group-based educational interventions with a focus on the transition to adulthood for young, ASD individuals without intellectual disability (ID). As a result of this systematic search, 21 studies out of 163 were found to be eligible for inclusion. We observed considerable heterogeneity across the studies, in terms of effect sizes and intervention design, delivery, and the comparison of controls. Strong evidence was found in favor of social-skills training and cognitive-behavioral therapy interventions. Professionals should consider group-based psychoeducational intervention to be an appropriate and relevant service for young subjects with ASD without ID transitioning to adulthood. Further research is needed on larger samples using multicentric designs to validate efficacy before generalization.
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Affiliation(s)
- Raphael Chancel
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier cedex 05, France.,Faculté de Médecine, Université de Montpellier, Montpellier, France
| | - Stephanie Miot
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier cedex 05, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.,Gerontology Centre, Antonin Balmès, University Hospital of Montpellier, CHU de Montpellier, Université de Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier, France
| | - Florine Dellapiazza
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier cedex 05, France
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux, CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier cedex 05, France. .,Faculté de Médecine, Université de Montpellier, Montpellier, France. .,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.
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The Kind of Friend I Think I Am: Perceptions of Autistic and Non-autistic Young Adults. J Autism Dev Disord 2022:10.1007/s10803-022-05573-4. [DOI: 10.1007/s10803-022-05573-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/25/2022]
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Factor RS, Rea HM, Laugeson EA, Scarpa A. Examining Feasibility and Outcomes of the PEERS® for Preschoolers Program. J Autism Dev Disord 2022; 53:1821-1833. [PMID: 35267147 DOI: 10.1007/s10803-022-05502-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
Abstract
Social impairments characteristic of autism spectrum disorder (ASD) are evident in early childhood and often worsen. There is a paucity of evidence-based interventions explicitly targeting social skill development for young children with ASD and few actively integrate caregivers. The PEERS® program, an evidence-based caregiver-assisted social skills program, was extended for young children with ASD (i.e., PEERS® for Preschoolers (P4P)). This pilot study expands upon initial results by examining the feasibility of a briefer intervention period and the effectiveness in improving child social skills among 15 children with ASD. Results suggest P4P recruitment, participant retention, and implementation are feasible across clinicians and sites. Further, P4P appears to improve social skills, maintained post-intervention. Future research might examine mechanisms that lead to results.
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Affiliation(s)
- Reina S Factor
- Department of Psychology, Virginia Tech 109 Williams Hall, 890 Drillfield Drive, Blacksburg, VA, 24061, USA. .,Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA, 24061, USA. .,Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 300 Medical Plaza, Los Angeles, CA, 90095, USA.
| | - Hannah M Rea
- Research in Autism and the Brain Lab, University of Washington, CHDD Box 357920, Seattle, WA, 98195, USA
| | - Elizabeth A Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 300 Medical Plaza, Los Angeles, CA, 90095, USA
| | - Angela Scarpa
- Department of Psychology, Virginia Tech 109 Williams Hall, 890 Drillfield Drive, Blacksburg, VA, 24061, USA.,Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA, 24061, USA
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Drüsedau L, Schoba A, Conzelmann A, Sokolov A, Hautzinger M, Renner TJ, Barth GM. A structured group intervention (TüTASS) with focus on self-perception and mindfulness for children with autism spectrum disorder, ASD. A pilot study. Eur Arch Psychiatry Clin Neurosci 2022; 272:177-185. [PMID: 34240267 PMCID: PMC8866376 DOI: 10.1007/s00406-021-01281-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 06/08/2021] [Indexed: 01/21/2023]
Abstract
Autism spectrum disorders (ASD) represent a set of long-lasting severe neurodevelopmental conditions and effective therapeutic interventions are needed. Recent research points to the importance of including mindfulness-based elements to improve emotion and body perception in the psychotherapy of patients with ASD. Therefore, we developed a structured group psychotherapy program The Tübinger Training for Autism Spectrum Disorders (Tübinger Training für Autismus-Spektrum-Störungen; TüTASS) which focuses on mindfulness-based training elements. This pilot study accompanying the TüTASS reports the first results on the feasibility of the program with a pre-post comparison of 25 treated children with ASD. The psychometric assessment comprised five standardized questionnaires/ scales evaluating on the basis of parents and patients self-reports the child's social responsiveness, behavior, strengths and difficulties, quality of life, and depressive symptoms before and after training completion. The results indicated that upon training completion, symptoms with respect to emotional and social problems, externalizing behavior, and attentional and schizoid-compulsive behavior substantially declined. In a questionnaire assessing feasibility and quality of the group training, patients and parents found the therapy highly beneficial, especially as to the focus on emotions and body, and strengths and failures. This training program was developed to bridge the gap of lacking mindfulness-based interventions with the aim to optimize the course of ASD, especially with respect to behavioral disturbances and social-emotional problems.
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Affiliation(s)
- Laura Drüsedau
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Anja Schoba
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Annette Conzelmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Alexander Sokolov
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Tübingen, Germany
| | - Martin Hautzinger
- Department of Psychology, Clinical Psychology and Psychotherapy, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Tobias J. Renner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Gottfried M. Barth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
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11
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Factor RS, Rea HM, Dahiya AV, Albright J, Ollendick TH, Laugeson EA, Scarpa A. An Initial Pilot Study Examining Child Social Skills, Caregiver Styles, and Family Functioning in the PEERS® for Preschoolers Program for Young Autistic Children and their Caregivers. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 121:104152. [PMID: 34942441 DOI: 10.1016/j.ridd.2021.104152] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/15/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Social impairments characteristic of autism spectrum disorder (ASD) are evident in early childhood and worsen as the child matures. Though many interventions for young children exist, few specifically target social skills and involve caregivers. AIMS This pilot study examined PEERS® for Preschoolers, focusing on temporal change in child social skills, caregiver style, and family functioning in the context of a caregiver-assisted social skills intervention. This extension of the PEERS® program builds on the success of the intervention for older children, presenting skills in a developmentally appropriate manner to young autistic children and their caregivers. METHODS AND PROCEDURES The present pilot study used a non-concurrent multiple baseline design to examine the above variables with 15 autistic children (Mage = 4.87, SD = 1.25; 11 boys). Children and caregivers participated in PEERS® for Preschoolers groups, with each group randomly assigned three different baseline periods (1.5, 2, or 2.5 weeks) before beginning. OUTCOMES AND RESULTS Simulation Modeling Analysis (SMA) revealed concurrent improvements in social and caregiving skills, with subsequent changes in family functioning occurring over the course of this 16-session intervention. CONCLUSIONS AND IMPLICATIONS Future research will need to examine mechanisms of change in PEERS® for Preschoolers for children and caregivers. WHAT THIS PAPER ADDS There is a dearth of research that specifically examines social skills interventions for young autistic children that incorporates caregivers and examines family functioning as well. This paper is one of the first to evaluate the PEERS® for Preschoolers (P4P) intervention by: 1) exploring changes in child social skills, caregiver efficacy, and family functioning, and 2) analyzing the sequence of improvements in the aforementioned variables to measure systematic change. This pilot study presents results using appropriate methodology for a small sample size of children and caregivers. Results suggested concurrent improvements in social and caregiving skills and subsequent changes in family functioning. These can be built upon for further research on the PEERS® for Preschoolers intervention. This study supports PEERS® for Preschoolers as a feasible intervention that likely contributes to improvements for the child, caregiver in their relationship with their child and parenting styles in general, as well as functioning of the entire family. In sum, this work is essential to furthering the provision of a much needed service of social skills interventions for young autistic children.
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Affiliation(s)
- Reina S Factor
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States; Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 300 Medical Plaza, Los Angeles, CA 90095, United States.
| | - Hannah M Rea
- Research in Autism and the Brain Lab, University of Washington, CHDD Box 357920, Seattle, WA 98195, United States
| | - Angela V Dahiya
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
| | - Jordan Albright
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
| | - Thomas H Ollendick
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
| | - Elizabeth A Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 300 Medical Plaza, Los Angeles, CA 90095, United States
| | - Angela Scarpa
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
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12
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Factor RS, Glass L, Baertschi D, Laugeson EA. Remote PEERS ® for preschoolers: A pilot parent-mediated social skills intervention for young children with social challenges over telehealth. Front Psychiatry 2022; 13:1008485. [PMID: 36523874 PMCID: PMC9745198 DOI: 10.3389/fpsyt.2022.1008485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/09/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Social differences characteristic of autism spectrum disorder (ASD) and other developmental disabilities are evident in early childhood and are associated with later difficulties. Unfortunately, there is a paucity of evidence-based interventions explicitly targeting social skills development for young children, few actively integrate parents and caregivers, and even fewer have remote models. The importance of providing accessible, tailored services for families in the wake of the COVID-19 pandemic, prompted the creation of a parent-mediated telehealth version of Program for the Education and Enrichment of Relational Skills (PEERS®) for Preschoolers (P4P), a pre-existing, evidence-based social skills intervention for children 4-6 years focused on making and keeping friends. METHOD This methodological paper documents the implementation, feasibility, and satisfaction of a novel telehealth group-based delivery of P4P. RESULTS Qualitative results indicate acceptable feasibility and satisfaction. Additionally, following completion there was an increase in parental confidence in social coaching and increased use of child social skills. DISCUSSION Future work will evaluate quantitative outcomes and comparisons between delivery methods (e.g., telehealth vs. in-person).
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Affiliation(s)
- Reina S Factor
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Leila Glass
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Daliah Baertschi
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Elizabeth A Laugeson
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
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13
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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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14
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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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15
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Kylliäinen A, Häkkinen S, Eränen S, Rantanen K, Ebeling H, Bölte S, Helminen TM. Social competence group intervention (SOCO) for children with autism spectrum disorder: A pilot study. Scand J Psychol 2020; 61:835-845. [PMID: 32779231 DOI: 10.1111/sjop.12675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/17/2020] [Indexed: 11/27/2022]
Abstract
This study aimed to describe concept of social competence as a theoretical background for social skills group intervention for children with autism spectrum disorder (ASD). A model of social competence comprised of three components: social skills, social performance, and social adjustment. We also examined the feasibility and preliminary efficacy of the manualized Social Competence group intervention for children with autism spectrum disorder (SOCO) using a variety of outcome measures. The nine-month intervention included children groups, parental support groups and co-operation with teachers. A pilot study involved 23 children aged 7 to 12 years (n = 16 intervention, n = 7 control) and intervention outcomes were measured with questionnaires for parents and teachers, neuropsychological tests, and observations. The parents of the intervention group reported improvements in social skills and social adjustment, whereas the teachers reported increases in social performance. Findings also indicated that affect recognition skills, social overtures, and reactions to peers were improved in the intervention group. Although the evidence of the pilot study should be considered as preliminary, it gives some indication of the feasibility of the SOCO group intervention and supports the usability of the theoretical background and approach for multiple outcome measures.
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Affiliation(s)
- Anneli Kylliäinen
- Psychology, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Satu Häkkinen
- Ludus Oy Tutkimus ja kuntoutuspalvelut, Mäkitorpantie 3 B, Helsinki, FI-00620, Finland
| | - Sanelma Eränen
- Psychology, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Kati Rantanen
- Psychology, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | - Hanna Ebeling
- Pedego Research Unit, Clinic of Child Psychiatry, University of Oulu and Oulu University Hospital, Finland
| | - Sven Bölte
- Department of Women's and Children's Health, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Division of Neuropsychiatry, Center for Psychiatry Research Karolinska Institutet & Region Stockholm, Sweden.,Child and Adolescent Psychiatry, Region Stockholm, Sweden
| | - Terhi M Helminen
- Psychology, Faculty of Social Sciences, Tampere University, Tampere, Finland
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16
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Abstract
BACKGROUND Individuals with neurodevelopmental disorders demonstrate difficulty initiating and maintaining eye contact from early infancy into adulthood. However, interventions aimed at improving eye contact lack normative eye contact data to guide treatment. METHODS The current study quantified behaviors (e.g., eye contact, vocalizations, head/shoulder, and hand movement) exhibited by college students during social encounters to gather normative data regarding the duration of targeted behaviors. A latent profile analysis was also used to identify participants' patterns of responding. RESULTS AND DISCUSSION Participants engaged in high levels of eye contact (M =89.3% of time) and head/shoulder movement (M= 85.0% of time), moderate levels of vocalizations (M= 65.0% of time), and low levels of hand movement (M =35% of time). Results highlight the need for social skills training procedures to target multiple behaviors in conjunction with eye contact and vocalizations. In addition, studies evaluating treatment packages or assessing the relationship between eye contact and other variables (e.g., physiological responses) may use these normative data to inform decisions.
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17
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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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18
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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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19
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Parsons L, Cordier R, Munro N, Joosten A. A Randomized Controlled Trial of a Play-Based, Peer-Mediated Pragmatic Language Intervention for Children With Autism. Front Psychol 2019; 10:1960. [PMID: 31611828 PMCID: PMC6776827 DOI: 10.3389/fpsyg.2019.01960] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 08/09/2019] [Indexed: 11/14/2022] Open
Abstract
PURPOSE This randomized controlled trial evaluated the effectiveness of a play-based pragmatic language intervention for children with autism. METHODS A sample of 71 children with autism were randomized to an intervention-first group (n = 28 analyzed) or waitlist-first (n = 34 analyzed) group. Children attended 10, weekly clinic play-sessions with a typically developing peer, and parents mediated practice components at home. The Pragmatics Observational Measure (POM-2) and the Social Emotional Evaluation (SEE) evaluated pragmatics before, after and 3-months following the intervention. RESULTS POM-2 gains were greatest for intervention-first participants (p = 0.031, d = 0.57). Treatment effects were maintained at 3-month follow-up (p < 0.001-0.05, d = 0.49-0.64). POM-2 scores were not significantly different in the clinic and home settings at follow-up. CONCLUSION Findings support the combination of play, peer-mediation, video-feedback and parent training to enhance pragmatic language in children with autism.
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Affiliation(s)
- Lauren Parsons
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Bentley, WA, Australia
| | - Reinie Cordier
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Bentley, WA, Australia
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | - Natalie Munro
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Bentley, WA, Australia
- Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| | - Annette Joosten
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Bentley, WA, Australia
- School of Allied Health, Australian Catholic University, Fitzroy, VIC, Australia
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20
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Lopata C, Donnelly JP, Thomeer ML, Rodgers JD, Volker MA, Booth AJ. Exploratory factor analysis of the Adapted Skillstreaming Checklist for children with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:437-446. [PMID: 31431041 DOI: 10.1177/1362361319868639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Adapted Skillstreaming Checklist measures social/social-communication skills and behavioral flexibility/regulation of children with autism spectrum disorder without intellectual disability. Prior studies provided support for the reliability and criterion-related validity of the Adapted Skillstreaming Checklist total score for these children; however, no studies have examined the Adapted Skillstreaming Checklist factor structure. This exploratory factor analysis examined the factor structure and internal consistency of parent ratings on the Adapted Skillstreaming Checklist for a sample of 331 children, ages 6-12 years, with autism spectrum disorder without intellectual disability. Results yielded a correlated three-factor solution. The individual factors and total score demonstrated very good internal consistency reliability. Findings supported the presence and interpretability of three subscales, as well as derivation of a total composite reflecting overall prosocial and adaptive skills and behaviors. Implications for assessment and research are discussed.
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Affiliation(s)
| | | | | | | | | | - Adam J Booth
- Institute for Autism Research, Canisius College, USA
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21
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Alcover C, Mairena MÁ, Mezzatesta M, Elias N, Díez-Juan M, Balañá G, González-Rodríguez M, Rodríguez-Medina J, Anguera MT, Arias-Pujol E. Mixed Methods Approach to Describe Social Interaction During a Group Intervention for Adolescents With Autism Spectrum Disorders. Front Psychol 2019; 10:1158. [PMID: 31231268 PMCID: PMC6559123 DOI: 10.3389/fpsyg.2019.01158] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/02/2019] [Indexed: 11/29/2022] Open
Abstract
Over the last 20 years, researchers have been mixing qualitative and quantitative approaches, but mixed methods research represents a new movement that arose in response to the currents of qualitative and quantitative research, considered separately. Little has been published on the use of polar coordinate analysis in psychotherapy. This type of analysis can provide detailed information and integrate the qualitative-quantitative analysis. Even less has been published on the analysis of ASD children’s behavior. The main aim of this study was to implement this mixed methods methodology to analyze patterns of social behaviors in a group of adolescents with ASD during a group social competence intervention program. Moreover, we wanted to see whether an observational scale could be combined fruitfully with polar coordinate analysis and to investigate whether typical ASD behaviors show similar interrelations (prospective and retrospective sequentialities) as behaviors observed in psychotherapy. We used an adaptation from the Social Skills Training Program (UC Davis, California). We observed that each participant took a unique course, increasing or decreasing the number and quality of their social behaviors. In accordance with previous literature, results suggest some increment in the amount of appropriate social conduct. We did not detect a generalized progress pattern but agreed that there were changes between the beginning and end of the intervention. Therefore, we consider that observational methodology is useful in the field of psychotherapy and ASD, offering detailed information about changes and development that cannot be obtained with other traditional measures, such as questionnaires.
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Affiliation(s)
- Carlota Alcover
- Faculty of Psychology, Education and Sports Sciences, Ramon Llull University, Barcelona, Spain.,Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, Esplugues de Llobregat, Spain
| | - Ma Ángeles Mairena
- Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, Esplugues de Llobregat, Spain.,Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Marcela Mezzatesta
- Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, Esplugues de Llobregat, Spain.,Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Neus Elias
- Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, Esplugues de Llobregat, Spain.,Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - María Díez-Juan
- Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, Esplugues de Llobregat, Spain.,Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Gemma Balañá
- Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, Esplugues de Llobregat, Spain.,Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Mireia González-Rodríguez
- Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, Esplugues de Llobregat, Spain.,Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Jairo Rodríguez-Medina
- Center for Transdisciplinary Research in Education, University of Valladolid, Valladolid, Spain
| | - M Teresa Anguera
- Faculty of Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Eulàlia Arias-Pujol
- Faculty of Psychology, Education and Sports Sciences, Ramon Llull University, Barcelona, Spain
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22
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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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23
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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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Rabin SJ, Israel-Yaacov S, Laugeson EA, Mor-Snir I, Golan O. A randomized controlled trial evaluating the Hebrew adaptation of the PEERS®
intervention: Behavioral and questionnaire-based outcomes. Autism Res 2018; 11:1187-1200. [DOI: 10.1002/aur.1974] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 04/05/2018] [Accepted: 05/03/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Shai Joseph Rabin
- Department of Psychology, Faculty of Social Sciences; Bar-Ilan University; Ramat Gan, 5290002 Israel
| | - Sandra Israel-Yaacov
- Department of Psychology, Faculty of Social Sciences; Bar-Ilan University; Ramat Gan, 5290002 Israel
- Association for Children at Risk. 13 Gush Etzion st; Givat-Shmuel Israel
| | - Elizabeth A. Laugeson
- Semel Institute for Neuroscience and Human Behavior; University of California Los Angeles; Los Angeles, CA 90024
| | - Irit Mor-Snir
- Association for Children at Risk. 13 Gush Etzion st; Givat-Shmuel Israel
| | - Ofer Golan
- Department of Psychology, Faculty of Social Sciences; Bar-Ilan University; Ramat Gan, 5290002 Israel
- Association for Children at Risk. 13 Gush Etzion st; Givat-Shmuel Israel
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25
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Psychometric Properties of the Adapted Skillstreaming Checklist for High-functioning Children with ASD. J Autism Dev Disord 2018; 47:2723-2732. [PMID: 28593595 DOI: 10.1007/s10803-017-3189-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study examined the reliability and criterion-related validity of parent ratings on the Adapted Skillstreaming Checklist (ASC) for a sample of 275 high-functioning children, ages 6-12 years, with ASD. Internal consistency for the total sample was 0.92. For two subsamples, test-retest reliability was very good at the 6-week and good at the 9-month intervals. Child age, IQ, and language abilities were unrelated to the ASC score. The ASC total score was inversely and strongly related to parent ratings of ASD symptom severity. Significant positive correlations (moderate-to-high) were found between the ASC and prosocial skills scales and significant negative correlations (low-to-moderate) with problem behavior scales on a broad measure of child functioning. Implications and suggestions for future study are discussed.
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26
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Floress MT, Zoder-Martell K, Schaub R. Social skills plus relaxation training with a child with ASD in the schools. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 71:200-213. [PMID: 29054024 DOI: 10.1016/j.ridd.2017.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 10/04/2017] [Accepted: 10/12/2017] [Indexed: 06/07/2023]
Abstract
A social skills plus relaxation training (SSRT) program was developed using direct training, relaxation training, and reinforcement principles. The aim was to examine the effectiveness of SSRT on increasing the frequency of three target behaviors for one 8-year-old, student classified with autism spectrum disorder (ASD). A multiple-baseline across behaviors design was used to evaluate the effects of SSRT. During baseline, intervention, and maintenance sessions the student's responses were videotaped and then subsequently viewed and coded after the session. During intervention, the student's correct responses for the targeted social skills increased and were maintained 17 weeks after SSRT ended. This study adds support for the use of this SSRT program in a school setting with children who have ASD.
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Affiliation(s)
- Margaret T Floress
- Eastern Illinois University, 600 Lincoln Avenue, Charleston, IL 61920, USA.
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27
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D'Amico M, Lalonde C. The Effectiveness of Art Therapy for Teaching Social Skills to Children With Autism Spectrum Disorder. ART THERAPY 2017. [DOI: 10.1080/07421656.2017.1384678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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28
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Adams R, Taylor J, Duncan A, Bishop S. Peer Victimization and Educational Outcomes in Mainstreamed Adolescents with Autism Spectrum Disorder (ASD). J Autism Dev Disord 2017; 46:3557-3566. [PMID: 27565652 DOI: 10.1007/s10803-016-2893-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The majority of adolescents with ASD spend a significant amount of the school day in general education settings; yet, many of these students exhibit problems at school. The current manuscript examined whether specific types of peer victimization were associated with a range of educational outcomes. Participants from study 1 included parents of 1221 adolescents from the Interactive Autism Network. Study 2 included 54 adolescent males and one of their parents that were recruited from a clinic registry. Both studies found that all types of victimization were associated with educational outcomes. These findings indicate that, in addition to improving overall well-being of students with ASD, reducing peer victimization could have positive effects on educational performance of these students.
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Affiliation(s)
- Ryan Adams
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 4002, Cincinnati, OH, 45229, USA.
| | | | - Amie Duncan
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 4002, Cincinnati, OH, 45229, USA
| | - Somer Bishop
- University of California San Francisco, San Francisco, CA, USA
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29
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Évaluation de la prise en charge institutionnelle d’enfants atteints d’un trouble envahissant du développement. EVOLUTION PSYCHIATRIQUE 2017. [DOI: 10.1016/j.evopsy.2016.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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30
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Parsons L, Cordier R, Munro N, Joosten A, Speyer R. A systematic review of pragmatic language interventions for children with autism spectrum disorder. PLoS One 2017; 12:e0172242. [PMID: 28426832 PMCID: PMC5398499 DOI: 10.1371/journal.pone.0172242] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 02/01/2017] [Indexed: 11/19/2022] Open
Abstract
There is a need for evidence based interventions for children with autism spectrum disorder (ASD) to limit the life-long, psychosocial impact of pragmatic language impairments. This systematic review identified 22 studies reporting on 20 pragmatic language interventions for children with ASD aged 0-18 years. The characteristics of each study, components of the interventions, and the methodological quality of each study were reviewed. Meta-analysis was conducted to assess the effectiveness of 15 interventions. Results revealed some promising approaches, indicating that active inclusion of the child and parent in the intervention was a significant mediator of intervention effect. Participant age, therapy setting or modality were not significant mediators between the interventions and measures of pragmatic language. The long-term effects of these interventions and the generalisation of learning to new contexts is largely unknown. Implications for clinical practice and directions for future research are discussed.
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Affiliation(s)
- Lauren Parsons
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
| | - Reinie Cordier
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
| | - Natalie Munro
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Annette Joosten
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
| | - Renée Speyer
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
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31
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Targeting Heterogeneity and Comorbidity in Children with Autism Spectrum Disorder Through the Resilience Builder Group Therapy Program. CHILD & YOUTH CARE FORUM 2017. [DOI: 10.1007/s10566-017-9394-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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32
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Abstract
Autism spectrum disorders (ASDs) are neurodevelopmental disorders with early onset, characterized by deficits in social communication and repetitive and restricted interests and activities. A growing number of studies over the last 10 years support the efficacy of behaviorally based interventions in ASD for the improvement of social communication and behavioral functioning. In contrast, research on neurobiological based therapies for ASD is still at its beginnings. In this article, we will provide a selective overview of both well-established evidence-based treatments and novel interventions and drug treatments based on neurobiological principles aiming at improving core symptoms in ASD. Directions and options for future research on treatment in ASD are discussed.
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Affiliation(s)
- L Poustka
- Clinic for Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| | - I Kamp-Becker
- Clinic for Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
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33
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Matthews NL, Goldberg WA. Theory of mind in children with and without autism spectrum disorder: Associations with the sibling constellation. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 22:311-321. [PMID: 29671641 DOI: 10.1177/1362361316674438] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The two prior studies that have examined associations between the sibling constellation and theory of mind in autism spectrum disorder yielded discrepant findings. Thus, efforts to better understand the sibling-theory of mind link in autism spectrum disorder are necessary. This study examined a sample of prekindergarten- and kindergarten-aged (i.e. 4-6 years) typically developing children ( n = 39) and verbal children with autism spectrum disorder ( n = 61). Sibling presence, number of siblings, and having younger and older siblings were positively associated with theory of mind in typically developing children, but not in the full sample of children with autism spectrum disorder. However, in the subgroup of children with autism spectrum disorder without sibling recurrence, the presence of at least one older sibling was positively associated with theory of mind. Findings expand previous limited research on the sibling-theory of mind link in children with autism spectrum disorder by demonstrating a potential difference in the influence of the sibling constellation between children from simplex and multiplex families.
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34
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Weston L, Hodgekins J, Langdon PE. Effectiveness of cognitive behavioural therapy with people who have autistic spectrum disorders: A systematic review and meta-analysis. Clin Psychol Rev 2016; 49:41-54. [DOI: 10.1016/j.cpr.2016.08.001] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 06/30/2016] [Accepted: 08/02/2016] [Indexed: 01/17/2023]
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35
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Finke EH. Friendship: Operationalizing the Intangible to Improve Friendship-Based Outcomes for Individuals With Autism Spectrum Disorder. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2016; 25:654-663. [PMID: 27716859 DOI: 10.1044/2016_ajslp-15-0042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 03/12/2016] [Indexed: 05/25/2023]
Abstract
PURPOSE Individuals with autism spectrum disorder (ASD) have social deficits that affect making and maintaining friends. Many empirically tested methods to address these social deficits are available, yet difficulties related to the establishment and maintenance of authentic friendships persist. METHOD This viewpoint article (a) briefly reviews the current state of the science relative to social and friendship skills training for individuals with ASD, (b) considers the potential links (or lack thereof) between current social and friendship skill interventions for individuals with ASD and outcomes related to making and maintaining friends, (c) examines how friendship-related outcomes might be maximized, and (d) proposes a framework for intervention planning that may promote these valued outcomes. RESULTS There are several key concepts to consider in planning intervention targeting friendship as an outcome. These concepts include (a) equal status, (b) mutually motivating and authentic opportunities for interaction, and (c) frequent opportunities for interaction. CONCLUSIONS There are many aspects about friendship development that cannot be controlled or contrived. Much is still to be learned about the achievement of better friendships for individuals with ASD. Reconceptualizing the way we design intervention may promote better outcomes for individuals on the autism spectrum.
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36
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Hebron J, Oldfield J, Humphrey N. Cumulative risk effects in the bullying of children and young people with autism spectrum conditions. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 21:291-300. [DOI: 10.1177/1362361316636761] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Students with autism are more likely to be bullied than their typically developing peers. However, several studies have shown that their likelihood of being bullied increases in the context of exposure to certain risk factors (e.g. behaviour difficulties and poor peer relationships). This study explores vulnerability to bullying from a cumulative risk perspective, where the number of risks rather than their nature is considered. A total of 722 teachers and 119 parents of young people with autism spectrum conditions participated in the study. Established risk factors were summed to form a cumulative risk score in teacher and parent models. There was evidence of a cumulative risk effect in both models, suggesting that as the number of risks increased, so did exposure to bullying. A quadratic effect was found in the teacher model, indicating that there was a disproportionate increase in the likelihood of being bullied in relation to the number of risk factors to which a young person was exposed. In light of these findings, it is proposed that more attention needs to be given to the number of risks to which children and young people with autism spectrum conditions are exposed when planning interventions and providing a suitable educational environment.
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37
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Judgments of Nonverbal Behaviour by Children with High-Functioning Autism Spectrum Disorder: Can they Detect Signs of Winning and Losing from Brief Video Clips? J Autism Dev Disord 2016; 46:2916-23. [PMID: 27306454 DOI: 10.1007/s10803-016-2839-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Typically developing children are able to judge who is winning or losing from very short clips of video footage of behaviour between active match play across a number of sports. Inferences from "thin slices" (short video clips) allow participants to make complex judgments about the meaning of posture, gesture and body language. This study extends the use of the thin slice research paradigm to children with high-functioning autism spectrum disorder (ASD). We tested 38 children with ASD, in two age groups: 15 participants aged 5-8 years and 23 participants aged 9-13 years. We found that the children with ASD had a rate of accuracy similar to that of typically developing peers tested in a previous study.
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38
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Okuno H, Yamamoto T, Tatsumi A, Mohri I, Taniike M. Simultaneous Training for Children with Autism Spectrum Disorder and Their Parents with a Focus on Social Skills Enhancement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13060590. [PMID: 27314372 PMCID: PMC4924047 DOI: 10.3390/ijerph13060590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 05/27/2016] [Accepted: 06/07/2016] [Indexed: 11/18/2022]
Abstract
The objective of this study was to evaluate the effectiveness of simultaneous training for children with autism spectrum disorder (ASD) and their parents, with a focus on social skills enhancement (STSSE) by evaluating behavioral changes in children with ASD and changes in family functioning. STSSE was conducted on 17 children of elementary school age with ASD and their parents. Changes in scores on the social skills scale for education (SS-scale), the child behavior checklist, the Feetham Family Functioning Survey (FFFS), and the confidence degree questionnaire for families (CDQ) were used to assess the effectiveness of STSSE. Improvements were seen for “Communication Skills” on the children’s SS-scale (p = 0.029). Significant improvements were seen in the mothers’ FFFS scores for “The 4th factor: illness and worries” (p = 0.016) and in the median CDQ scores for one of 18 items after STSSE (p = 0.01). Although additional studies with larger sample sizes will be necessary before these findings are generalizable, the positive changes seen in both parents and children as a result of STSSE are promising.
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Affiliation(s)
- Hiroko Okuno
- United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan.
| | - Tomoka Yamamoto
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan.
| | - Aika Tatsumi
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan.
| | - Ikuko Mohri
- United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan.
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan.
| | - Masako Taniike
- United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan.
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan.
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39
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Freitag CM, Jensen K, Elsuni L, Sachse M, Herpertz-Dahlmann B, Schulte-Rüther M, Hänig S, von Gontard A, Poustka L, Schad-Hansjosten T, Wenzl C, Sinzig J, Taurines R, Geißler J, Kieser M, Cholemkery H. Group-based cognitive behavioural psychotherapy for children and adolescents with ASD: the randomized, multicentre, controlled SOSTA-net trial. J Child Psychol Psychiatry 2016; 57:596-605. [PMID: 26715086 DOI: 10.1111/jcpp.12509] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/04/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Group-based psychotherapy in Autism Spectrum Disorder (ASD) has predominantly been studied in the United States by small studies in school-aged children without long-term follow-up. We report results of a large, confirmatory, multicentre randomized-controlled phase-III trial in children and adolescents studying the ASD specific, manualized group-based cognitive behavioural SOSTA-FRA approach. METHODS High-functioning ASD individuals aged 8-19 years old were randomized to 12 sessions SOSTA-FRA or treatment as usual. Primary outcomes were change in total raw score of the parent-rated Social Responsiveness Scale (pSRS) between baseline (T2) and end of intervention (T4), and between T2 and 3 months after end of intervention (T5). TRIAL REGISTRATION ISRCTN94863788. RESULTS Between 20/5/2010 and 14/2/2013, n = 320 ASD patients were screened, n = 228 patients were randomized, and N = 209 analysed. Mean pSRS difference between groups at T4 was -6.5 (95% CI -11.6 to - 1.4; p = .013), and at T5 -6.4 (-11.5 to -1.3, p = .015). Pre-treatment SRS and IQ were positively associated with stronger improvement at T4 and T5. CONCLUSIONS Short-term ASD-specific add-on group-based psychotherapy has shown postintervention efficacy with regard to parent-rated social responsiveness predominantly in male high-functioning children and adolescents with ASD. Future studies should implement blinded standardized observational measures of peer-related social interaction.
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Affiliation(s)
- Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Katrin Jensen
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Leyla Elsuni
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Michael Sachse
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Martin Schulte-Rüther
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Susann Hänig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Hospital Homburg, Saarbrücken, Germany
| | - Alexander von Gontard
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Hospital Homburg, Saarbrücken, Germany
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.,Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Tanja Schad-Hansjosten
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Christina Wenzl
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Köln, Cologne, Germany
| | - Judith Sinzig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Köln, Cologne, Germany.,Department of Child and Adolescent Psychiatry, LVR Klinik Bonn, Bonn, Germany
| | - Regina Taurines
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Julia Geißler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Meinhard Kieser
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Hannah Cholemkery
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe University Frankfurt am Main, Frankfurt, Germany
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40
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Tanner K, Hand BN, O'Toole G, Lane AE. Effectiveness of Interventions to Improve Social Participation, Play, Leisure, and Restricted and Repetitive Behaviors in People With Autism Spectrum Disorder: A Systematic Review. Am J Occup Ther 2015; 69:6905180010p1-12. [PMID: 26356653 DOI: 10.5014/ajot.2015.017806] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
People with autism spectrum disorder (ASD) commonly experience difficulties with social participation, play, and leisure along with restricted and repetitive behaviors that can interfere with occupational performance. The objective of this systematic review was to evaluate current evidence for interventions within the occupational therapy scope of practice that address these difficulties. Strong evidence was found that social skills groups, the Picture Exchange Communication System, joint attention interventions, and parent-mediated strategies can improve social participation. The findings were less conclusive for interventions to improve play and leisure performance and to decrease restricted and repetitive behaviors, but several strategies showed promise with moderately strong supporting evidence. Occupational therapists should be guided by evidence when considering interventions to improve social participation, play, leisure, and restricted and repetitive behaviors in people with ASD. Additional research using more robust scientific methods is needed for many of the currently available strategies.
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Affiliation(s)
- Kelly Tanner
- Kelly Tanner, PhD, OTR/L, is Occupational Therapy Research Coordinator, Nationwide Children's Hospital, Columbus, OH, and Lecturer, Occupational Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus;
| | - Brittany N Hand
- Brittany N. Hand, MOT, OTR/L, is PhD Student, Occupational Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | - Gjyn O'Toole
- Gjyn O'Toole, MEdStud, GradDip TEFL, BA, Dip Occ Therapy, is Senior Lecturer, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Alison E Lane
- Alison E. Lane, PhD, OTR/L, is Associate Professor, University of Newcastle, Callaghan, New South Wales, Australia
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41
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Olsson NC, Tammimies K, Bölte S. Manualized social skills group training for children and adolescents with higher functioning autism spectrum disorder: protocol of a naturalistic multicenter, randomized controlled trial. ACTA ACUST UNITED AC 2015. [DOI: 10.3402/tdp.v3.29825] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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42
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Jonsson U, Choque Olsson N, Bölte S. Can findings from randomized controlled trials of social skills training in autism spectrum disorder be generalized? The neglected dimension of external validity. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2015; 20:295-305. [PMID: 25964654 DOI: 10.1177/1362361315583817] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Systematic reviews have traditionally focused on internal validity, while external validity often has been overlooked. In this study, we systematically reviewed determinants of external validity in the accumulated randomized controlled trials of social skills group interventions for children and adolescents with autism spectrum disorder. We extracted data clustered into six overarching themes: source population, included population, context, treatment provider, treatment intervention, and outcome. A total of 15 eligible randomized controlled trials were identified. The eligible population was typically limited to high-functioning school-aged children with autism spectrum disorder, and the included population was predominantly male and Caucasian. Scant information about the recruitment of participants was provided, and details about treatment providers and settings were sparse. It was not evident from the trials to what extent acquired social skills were enacted in everyday life and maintained over time. We conclude that the generalizability of the accumulated evidence is unclear and that the determinants of external validity are often inadequately reported. At this point, more effectiveness-oriented randomized controlled trials of equally high internal and external validity are needed. More attention to the determinants of external validity is warranted when this new generation of randomized controlled trials are planned and reported. We provide a tentative checklist for this purpose.
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Affiliation(s)
- Ulf Jonsson
- Department of Women's and Children's Health, Karolinska Institutet, Sweden The National Board of Health and Welfare, Sweden
| | - Nora Choque Olsson
- Department of Women's and Children's Health, Karolinska Institutet, Sweden Center for Psychiatry Research, Stockholm County Council, Sweden
| | - Sven Bölte
- Department of Women's and Children's Health, Karolinska Institutet, Sweden Center for Psychiatry Research, Stockholm County Council, Sweden
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43
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Chown N. Do Researchers Evaluate Psychosocial Interventions for Autism from the Perspective of the Three Dominant Cognitive Autism Theories? REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2015. [DOI: 10.1007/s40489-015-0049-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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44
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Soorya LV, Siper PM, Beck T, Soffes S, Halpern D, Gorenstein M, Kolevzon A, Buxbaum J, Wang AT. Randomized comparative trial of a social cognitive skills group for children with autism spectrum disorder. J Am Acad Child Adolesc Psychiatry 2015; 54:208-216.e1. [PMID: 25721186 PMCID: PMC4346205 DOI: 10.1016/j.jaac.2014.12.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 12/15/2014] [Accepted: 12/17/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study evaluated the efficacy of a targeted social skills training group in school-aged children with autism spectrum disorder (ASD). The intervention, Seaver-NETT (Nonverbal communication, Emotion recognition, and Theory of mind Training), is a 12-session cognitive-behavioral intervention (CBI) for verbal, school-aged children targeting ASD-specific social behavioral impairments. METHOD Sixty-nine children with ASD, 8 to 11 years of age, with verbal IQs greater than 70, participated in a randomized comparative trial to examine the efficacy of NETT relative to a facilitated play group. Treatment outcomes included caregiver reports of social behavior and neuropsychological assessments of social cognition conducted by blinded raters. Outcomes were collected at baseline, endpoint, and 3 months posttreatment. RESULTS Significant improvements were found on social behavior outcomes such as nonverbal communication, empathic responding, and social relations in the NETT condition relative to the active control at endpoint. Verbal IQ moderated the interaction effect on social behavior, with higher verbal IQ associated with improvements in the CBI condition. No significant improvements were found on social cognitive outcomes. No significant group differences were found at 3-month follow-up conducted with approximately half the sample (n = 34). CONCLUSION These data indicate that targeted CBI social skills groups such as NETT improve social communication deficits in verbal, school-aged children with ASD. The moderating effects of high verbal IQ suggest a need to consider participant and treatment characteristics associated with outcomes in future studies. Clinical trial registration information-Neural and Behavioral Outcomes of Social Skills Groups in Children With Autism Spectrum Disorder; https://clinicaltrials.gov; NCT01190917.
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Affiliation(s)
| | - Paige M Siper
- Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai, New York
| | - Todd Beck
- Rush University Medical Center, Chicago
| | - Sarah Soffes
- Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai, New York
| | - Danielle Halpern
- Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai, New York
| | - Michelle Gorenstein
- Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai, New York
| | - Alexander Kolevzon
- Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai, New York
| | - Joseph Buxbaum
- Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai, New York
| | - A Ting Wang
- Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai, New York
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Hirvikoski T, Jonsson U, Halldner L, Lundequist A, de Schipper E, Nordin V, Bölte S. A Systematic Review of Social Communication and Interaction Interventions for Patients with Autism Spectrum Disorder. Scand J Child Adolesc Psychiatr Psychol 2015. [DOI: 10.21307/sjcapp-2015-016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Wood JJ, Fujii C, Renno P, Van Dyke M. Impact of cognitive behavioral therapy on observed autism symptom severity during school recess: a preliminary randomized, controlled trial. J Autism Dev Disord 2014; 44:2264-76. [PMID: 24671750 DOI: 10.1007/s10803-014-2097-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study compared cognitive behavioral therapy (CBT) and treatment-as-usual (TAU) in terms of effects on observed social communication-related autism symptom severity during unstructured play time at school for children with autism spectrum disorders (ASD). Thirteen children with ASD (7-11 years old) were randomly assigned to 32 sessions of CBT or community-based psychosocial treatment (TAU) for 16 weeks. The CBT program is based on the memory retrieval competition model and emphasizes the development of perspective-taking through guided behavioral experimentation supplemented with reflective Socratic discussion and supported by parent training and school consultation to promote generalization of social communication and emotion regulation skills. Trained observers blind to treatment condition observed each child during recess on two separate days at baseline and again at posttreatment, using a structured behavioral observation system that generates frequency scores for observed social communication-related autism symptoms. CBT outperformed TAU at posttreatment on the frequency of self-isolation, the proportion of time spent with peers, the frequency of positive or appropriate interaction with peers, and the frequency of positive or appropriate peer responses to the target child (d effect size range 1.34-1.62). On average, children in CBT were engaged in positive or appropriate social interaction with peers in 68.6% of observed intervals at posttreatment, compared to 25% of intervals for children in TAU. Further investigation of this intervention modality with larger samples and follow-up assessments is warranted.
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Affiliation(s)
- Jeffrey J Wood
- Department of Education, University of California, Los Angeles, Moore Hall, Box 951521, Los Angeles, CA, 90095, USA,
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Measuring social communication behaviors as a treatment endpoint in individuals with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2014; 19:622-36. [DOI: 10.1177/1362361314542955] [Citation(s) in RCA: 134] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Social communication impairments are a core deficit in autism spectrum disorder. Social communication deficit is also an early indicator of autism spectrum disorder and a factor in long-term outcomes. Thus, this symptom domain represents a critical treatment target. Identifying reliable and valid outcome measures for social communication across a range of treatment approaches is essential. Autism Speaks engaged a panel of experts to evaluate the readiness of available measures of social communication for use as outcome measures in clinical trials. The panel held monthly conference calls and two face-to-face meetings over 14 months. Key criteria used to evaluate measures included the relevance to the clinical target, coverage of the symptom domain, and psychometric properties (validity and reliability, as well as evidence of sensitivity to change). In all, 38 measures were evaluated and 6 measures were considered appropriate for use, with some limitations. This report discusses the relative strengths and weaknesses of existing social communication measures for use in clinical trials and identifies specific areas in need of further development.
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Dekker V, Nauta MH, Mulder EJ, Timmerman ME, de Bildt A. A randomized controlled study of a social skills training for preadolescent children with autism spectrum disorders: generalization of skills by training parents and teachers? BMC Psychiatry 2014; 14:189. [PMID: 24989854 PMCID: PMC4100026 DOI: 10.1186/1471-244x-14-189] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 06/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social skills training (SST) is a common intervention for children with autism spectrum disorders (ASDs) to improve their social and communication skills. Despite the fact that SSTs are often applied in clinical practice, the evidence for the effectiveness of these trainings for children with ASD is inconclusive. Moreover, long term outcome and generalization of learned skills are little evaluated. Additionally, there is no research on the influence of involvement of parents and teachers on effectiveness of SST and on the generalization of learned social skills to daily life. We expect parent and teacher involvement in SST to enhance treatment efficacy and to facilitate generalization of learned skills to daily life. METHOD/DESIGN In a randomized controlled trial (RCT) with three conditions, 120 participants with ASD at the end of primary school (10-12 years of calendar age) have been randomized to SST, SST-PTI (SST with Parent & Teacher Involvement), or care-as-usual. The SST consists of 18 group sessions of 1.5 hours for the children. In the SST-PTI condition, parents additionally participate in 8 parent sessions and parents and teachers are actively involved in homework assignments. Assessment takes place at three moments: before and immediately after the intervention period and at 6 months follow-up. Primary outcome is socialization, as an aspect of adaptive functioning. Secondary outcomes focus on specific social skills children learn during SST and on more general social skills pertaining to home and community settings from a multi-informant perspective. Additionally, possible predictors of treatment outcome will be assessed. DISCUSSION The current study is an RCT study evaluating SST in a large sample of Dutch children with ASD in a specific age range (10-12 years). Strengths of the study are the use of one manualized protocol, application of standardized and internationally used rating instruments, use of multiple raters, investigation of generalization of learned skills to daily life, and the evaluation of efficacy in the longer term by follow-up measures at 6 months after the end of training. TRIAL REGISTRATION NTR2405.
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Affiliation(s)
- Vera Dekker
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Accare Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
| | - Maaike H Nauta
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Accare Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands,Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
| | - Erik J Mulder
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Accare Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Marieke E Timmerman
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
| | - Annelies de Bildt
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Accare Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
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'Look at me when I am talking to you': evidence and assessment of social pragmatics interventions for children with autism and social communication disorders. Curr Opin Pediatr 2014; 26:259-64. [PMID: 24535501 DOI: 10.1097/mop.0000000000000075] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This article provides an analysis of the effectiveness of commonly used interventions for social pragmatic interventions for children with autism spectrum disorder (ASD) and social communication disorders. RECENT FINDINGS Several evidence-based social skills interventions are emerging, including peer mentoring, social skills groups, and video modeling. Social stories are effective as supports for improved interactions but generalization is limited. Research supports the need for multimodality and individualized treatment programs. Research validates that video and visual learning is highly effective with children with ASD when utilized with specific, appropriate targets. Multiple studies have shown that picture-based communication systems are effective at improving functional communication with moderate effects on social communication. Despite limitations in research, there is strong evidence in the existing literature for the role of alternative augmentative communication in improving both functional and social communication. SUMMARY Social pragmatic interventions when individualized are effective for improving language, adaptive behavior and social skills.
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Fletcher‐Watson S, McConnell F, Manola E, McConachie H. Interventions based on the Theory of Mind cognitive model for autism spectrum disorder (ASD). Cochrane Database Syst Rev 2014; 2014:CD008785. [PMID: 24652601 PMCID: PMC6923148 DOI: 10.1002/14651858.cd008785.pub2] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The 'Theory of Mind' (ToM) model suggests that people with autism spectrum disorder (ASD) have a profound difficulty understanding the minds of other people - their emotions, feelings, beliefs, and thoughts. As an explanation for some of the characteristic social and communication behaviours of people with ASD, this model has had a significant influence on research and practice. It implies that successful interventions to teach ToM could, in turn, have far-reaching effects on behaviours and outcome. OBJECTIVES To review the efficacy of interventions based on the ToM model for individuals with ASD. SEARCH METHODS In August 2013 we searched CENTRAL, Ovid MEDLINE, Embase, CINAHL, PsycINFO, ERIC, Social Services Abstracts, AutismData, and two trials registers. We also searched the reference lists of relevant papers, contacted authors who work in this field, and handsearched a number of journals. SELECTION CRITERIA Review studies were selected on the basis that they reported on an applicable intervention (linked to ToM in one of four clearly-defined ways), presented new randomised controlled trial data, and participants had a confirmed diagnosis of an autism spectrum disorder. Studies were selected by two review authors independently and a third author arbitrated when necessary. DATA COLLECTION AND ANALYSIS Risk of bias was evaluated and data were extracted by two review authors independently; a third author arbitrated when necessary. Most studies were not eligible for meta-analysis, the principal reason being mis-matching methodologies and outcome measures. Three small meta-analyses were carried out. MAIN RESULTS Twenty-two randomised trials were included in the review (N = 695). Studies were highly variable in their country of origin, sample size, participant age, intervention delivery type, and outcome measures. Risk of bias was variable across categories. There were very few studies for which there was adequate blinding of participants and personnel, and some were also judged at high risk of bias in blinding of outcome assessors. There was also evidence of some bias in sequence generation and allocation concealment. Not all studies reported data that fell within the pre-defined primary outcome categories for the review, instead many studies reported measures which were intervention-specific (e.g. emotion recognition). The wide range of measures used within each outcome category and the mixed results from these measures introduced further complexity when interpreting results.Studies were grouped into four main categories according to intervention target/primary outcome measure. These were: emotion recognition studies, joint attention and social communication studies, imitation studies, and studies teaching ToM itself. Within the first two of these categories, a sub-set of studies were deemed suitable for meta-analysis for a limited number of key outcomes.There was very low quality evidence of a positive effect on measures of communication based on individual results from three studies. There was low quality evidence from 11 studies reporting mixed results of interventions on measures of social interaction, very low quality evidence from four studies reporting mixed results on measures of general communication, and very low quality evidence from four studies reporting mixed results on measures of ToM ability. The meta-analysis results we were able to generate showed that interventions targeting emotion recognition across age groups and working with people within the average range of intellectual ability had a positive effect on the target skill, measured by a test using photographs of faces (mean increase of 0.75 points, 95% confidence interval (CI) 0.22 to 1.29 points, Z = 2.75, P < 0.006, four studies, N = 105). Therapist-led joint attention interventions can promote production of more joint attention behaviours within adult-child interaction (mean increase of 0.55 points, 95% CI 0.11 to 0.99 points, Z = 2.45, P value = 0.01, two studies, N = 88). Further analysis undermines this conclusion somewhat by demonstrating that there was no clear evidence that intervention can have an effect on joint attention initiations as measured using a standardised assessment tool (mean increase of 0.23 points, 95% CI -0.48 to 0.94 points, Z = 0.63, P value = 0.53, three studies, N = 92). No adverse effects were apparent. AUTHORS' CONCLUSIONS While there is some evidence that ToM, or a precursor skill, can be taught to people with ASD, there is little evidence of maintenance of that skill, generalisation to other settings, or developmental effects on related skills. Furthermore, inconsistency in findings and measurement means that evidence has been graded of 'very low' or 'low' quality and we cannot be confident that suggestions of positive effects will be sustained as high-quality evidence accumulates. Further longitudinal designs and larger samples are needed to help elucidate both the efficacy of ToM-linked interventions and the explanatory value of the ToM model itself. It is possible that the continuing refinement of the ToM model will lead to better interventions which have a greater impact on development than those investigated to date.
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Affiliation(s)
- Sue Fletcher‐Watson
- University of EdinburghMoray House School of EducationSt John's LandHolyrood RoadEdinburghUKEH8 8AQ
| | - Fiona McConnell
- University of EdinburghMoray House School of EducationSt John's LandHolyrood RoadEdinburghUKEH8 8AQ
| | - Eirini Manola
- Puzzle ‐ School for Children with AutismAmarousiou‐Chalandriou 108, MarousiAthensGreece15125
| | - Helen McConachie
- Newcastle UniversityInstitute of Health and SocietyNewcastle upon TyneUKNE1 4LP
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