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Afsharnejad B, Black MH, Falkmer M, Bölte S, Girdler S. The Methodological Quality and Intervention Fidelity of Randomised Controlled Trials Evaluating Social Skills Group Programs in Autistic Adolescents: A Systematic Review and Meta-analysis. J Autism Dev Disord 2024; 54:1281-1316. [PMID: 36681732 PMCID: PMC10981608 DOI: 10.1007/s10803-023-05893-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2023] [Indexed: 01/22/2023]
Abstract
A systematic review and meta-analysis were utilised to explore the methodological quality, program fidelity, and efficacy of social skills group programs (SSGPs) aiming to support autistic adolescents in navigating their everyday social worlds. The study evaluated the methodological quality and theoretical fidelity of studies, with a random effect meta-analysis conducted to summarise the overall efficacy of SSGP and its effect on social communication and interaction, behavioural/emotional challenges, adaptive functioning, and autism characteristics. Although findings from the 18 identified studies indicated an adjusted medium overall effect with these programs successfully supporting autistic adolescents' socialisation needs (g = 0. 60, p < 0.001), most studies demonstrated medium to low program fidelity despite their good methodological quality. Given the significant heterogeneity of SSGPs and variations in the design and measurement frameworks of efficacy studies, understanding the generalisability of the findings of this research is unclear.
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Affiliation(s)
- Bahareh Afsharnejad
- School of Allied Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia.
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia.
| | - Melissa H Black
- School of Allied Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia
- Division of Neuropsychiatry, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Marita Falkmer
- School of Education and Communication, CHILD, Swedish Institute for Disability Research, Jönköping University, Jönköping, Sweden
| | - Sven Bölte
- School of Allied Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia
- Division of Neuropsychiatry, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Sonya Girdler
- School of Allied Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia
- Division of Neuropsychiatry, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- School of Allied Health, University of Western Australia, Perth, WA, Australia
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Simmons GL, Corbett BA, Lerner MD, Wofford K, White SW. Social competence in autism: A structural equation modeling approach. Autism Res 2024; 17:761-774. [PMID: 38481386 DOI: 10.1002/aur.3108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/25/2024] [Indexed: 04/13/2024]
Abstract
Autistic individuals present with difficulties in social competence (e.g., navigating social interactions and fostering relationships). Clinical interventions widely target social cognition and social behavior, but there is inconsistent understanding of the underlying components of social competence. The present study used structural equation modeling to examine social cognition and social behavior and explore the relationship between these latent constructs. Autistic youth (ages 10-17; n = 219) and their caregivers participated in this study. Constructs of social cognition and social behavior were captured using caregiver-report and self-report rating scales, as well as observational measures and direct clinical assessments (e.g., NEPSY-II). Measurement models of social cognition and social behavior demonstrated adequate to good fit. Correlational models demonstrated adequate to poor fit, indicating latent constructs of social cognition and social behavior are not closely related in autistic youth. Exploratory examination of a subsample of male youth (n = 157) evidenced improved model fit of social behavior, specifically. Findings tease apart social cognition and social behavior as cohesive and separable constructs; results do not support a structural relationship between social cognition and social behavior. Noted treatment implications include consideration of how targeting social cognition and social behavior together or separately may support autistic youth's progress toward reaching their identified therapeutic goals and supporting their self-directed social development.
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Affiliation(s)
- G L Simmons
- TEACCH Autism Program, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Center for Youth Development and Intervention, Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - B A Corbett
- Department of Psychiatry & Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - M D Lerner
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
- AJ Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - K Wofford
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - S W White
- Center for Youth Development and Intervention, Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, 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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Gajre MP, Shah M, Pradhan SV, Aseri H. Examining the Impact of Group-Based Social Skills Intervention in Autistic Children Aged Eight to 15 Years. Cureus 2024; 16:e53376. [PMID: 38435203 PMCID: PMC10907971 DOI: 10.7759/cureus.53376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Autism spectrum disorder (ASD) is a neurological and developmental disorder, which poses challenges to social communication and behavior, particularly affecting social functioning. Individuals with ASD face significant social challenges, including difficulty understanding social cues and body language, limited ability to engage in reciprocal social interactions, and challenges with establishing empathy. A preference for routines and repetitive behaviors limits their ability to adapt to new or unexpected social situations. These problems tend to escalate during adolescence. These often cause distress to the individual as well as the caregivers. Group-based social skills interventions (GSSIs) are a widely used and effective modality for addressing core social impairments in children with autism. This study aims to assess the impact of GSSI on the broad age group of eight to 15 years, involving parents to enhance the transferability of children's social skills. Methods This was a single-arm interventional study where 30 verbal autistic children, aged eight to 15 years, with intelligence quotient (IQ) > 70 were enrolled after utilizing the Binet Kamat Test of Intelligence (BKT) to assess IQ and the Indian Scale for Assessment of Autism (ISAA) to grade severity of autism. The children received GSSI from interdisciplinary therapists for 12 sessions, on a weekly basis, lasting 90 minutes each for a period of three months. After each therapy session, parents received summaries of each session and were delegated reinforcing homework assignments to enable generalization and maintenance of the skills taught. Outcome measures were taken at three points in time by utilizing the Social Communication Questionnaire (SCQ) and the parent-rated Social Responsiveness Scale 2 (p-SRS-2): T1: pre-therapy at the time of enrolment; T2: immediately post-therapy at the end of three months of training; and T3: long-term follow-up, three months after the end of training. Results Mean SCQ scores were as follows: T1 = 21.87, T2 = 18.57, and T3 = 18.57 (p = 0.000). This progressive decline at T1, T2, and T3 indicated a decreasing trend in the severity of difficulties in the social communication domain. Mean p-SRS-2 scores were as follows: T1 = 73.00, T2 = 64.57, and T3 = 64.30 (p < 0.0001). This declining trend at T1, T2, and T3 suggested a statistically significant decrease in the severity of difficulties faced in various social aspects tested by the p-SRS-2, i.e., social awareness, social cognition, social communication, and social motivation, along with a reduction in restricted interests and repetitive behaviors (RRBs). Very strong correlation coefficients were obtained for SCQ scores (T1-T2 = 0.921, T1-T3 = 0.921, and T2-T3 = 1.000), as well as for p-SRS-2 scores (T1-T2 = 0.743, T1-T3 = 0.746, and T2-T3 = 0.989), which reinforced the statistical significance of the data. Conclusion GSSI is an effective parent-assisted intervention for adolescents with ASD, with effects lasting up to three months post-intervention.
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Affiliation(s)
- Mona P Gajre
- Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, IND
| | - Mansi Shah
- Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, IND
| | - Shreeya V Pradhan
- Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, IND
| | - Harshna Aseri
- Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, IND
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Corbett BA, Key AP, Klemencic ME, Muscatello RA, Jones D, Pilkington J, Burroughs C, Vandekar S. Investigating Social Competence in a Pilot Randomized Clinical Trial of a Theatre-Based Intervention Enhanced for Adults with Autism Spectrum Disorder. J Autism Dev Disord 2023:10.1007/s10803-023-06214-0. [PMID: 38109034 PMCID: PMC11182891 DOI: 10.1007/s10803-023-06214-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
Autism spectrum disorder (ASD) is characterized by challenges in social competence that persist in adulthood, yet few treatment options exist. A pilot randomized clinical trial (RCT) of a peer-mediated, theatre-based intervention with established efficacy in youth with ASD was examined in autistic adults. The final sample consisted of forty-seven 18-to-40-year-old participants randomized to the experimental (EXP N = 23) or waitlist control (WLC N = 24) condition. A multimodal, social interdependent model was employed to examine social competence changes in brain (incidental face memory (IFM) using event-related potentials), cognition (Wechsler Memory Scale-III), behavior (Contextual Assessment of Social Skills) and function (Social Responsiveness Scale (SRS); Adaptive Behavior Assessment Scale (ABAS) Social Composite). Using analysis of covariance in which pretest was controlled in the model, posttest between-group differences were observed on IFM (p = 0.016, η2 = 0.139, d = 0.79) and several social and adaptive functional (SRS, ABAS) outcomes in social communication and interaction (SCI) (p = 0.019, η2 = 0.121, d = -00.45), communication (p = 0.044 η2 = 0.09, d = -00.31), and motivation (p = 0.001, η2 = 0.229, d = -0.79) domains. At two-month follow-up, gains in social motivation remained (p = 0.041, η2 = 0.100, d = -0.77). The results offer preliminary support for a unique theatre-based social skills intervention for autistic adults who have few treatment options to enhance social competence. The trial was pre-registered with ClinicalTrials.gov (Identifier: NCT04349644).
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Affiliation(s)
- Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA.
- Department of Psychology, Vanderbilt University, Nashville, TN, USA.
| | - Alexandra P Key
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mark E Klemencic
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rachael A Muscatello
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA
| | - Dorita Jones
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA
| | - Jennifer Pilkington
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christina Burroughs
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Simon Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
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Lewandowska K, Węziak-Białowolska D. The impact of theatre on social competencies: a meta-analytic evaluation. Arts Health 2023; 15:306-337. [PMID: 36203325 DOI: 10.1080/17533015.2022.2130947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/15/2022] [Accepted: 09/14/2022] [Indexed: 10/10/2022]
Abstract
BACKGROUND There has been agrowing interest in using artistic interventions as a method of developing interpersonal competence. This paper presents a meta-analysis evaluating the impact of theatre interventions on social competencies. METHODS Twenty-one primary studies totaling 4064 participants were included, presenting evidence available since 1983. Included studies were assessed in terms of quality, heterogeneity, and publication bias. RESULTS Our findings indicated that active theatre participation significantly improved participants' empathic abilities, social communication, tolerance, and social interactions, with the largest pooled effect size for social communication (0.698) and the smallest for tolerance (0.156). Our findings did not corroborate the impact of theatre on self-concept. CONCLUSIONS This paper shows that theatre interventions have a positive impact on social competencies. The paper makes a methodological contribution by showing that randomized and non-randomized studies yielded comparably valid results.
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Affiliation(s)
- Kamila Lewandowska
- Aleksander Zelwerowicz National Academy of Dramatic Art in Warsaw, Warsaw, Poland
| | - Dorota Węziak-Białowolska
- Sustainability and Health Initiative (Shine), Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
- Centre for Evaluation and Analysis of Public Policies, Faculty of Philosophy, Jagiellonian University, Cracow, Poland
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7
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Chiu HM, Chen CT, Tsai CH, Li HJ, Wu CC, Huang CY, Chen KL. Theory of Mind Predicts Social Interaction in Children with Autism Spectrum Disorder: A Two-Year Follow-Up Study. J Autism Dev Disord 2023; 53:3659-3669. [PMID: 35829943 DOI: 10.1007/s10803-022-05662-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 10/17/2022]
Abstract
This two-year follow-up study examined the predictive relationships of theory of mind (ToM) to social interaction by reciprocal social behaviors (RSBs) and social functioning (SF) in 106 children with ASD. The results of the path analysis showed that the earlier ToM predicted children's current component RSBs (B = 3.53, SE = 1.86, p = 0.039) and the current SF (B = 1.79-1.87, SE = 0.03-0.34, p < 0.001). The aloof and passive social interaction styles predicted fewer turn-taking of RSBs (B = - 48.77 to - 111.17, p < 0.001) and fewer components of RSBs (B = - 36.30 to - 81.41, p < 0.001). This finding provides empirical evidence that ToM predicts social interaction in children with ASD.
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Affiliation(s)
- Hsiu-Man Chiu
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, No. 1 University Road, Tainan, 701, Taiwan R.O.C
- Department of Occupational Therapy, Tai An Hospital, Shuang Shi Branch, Tai-chung, Taiwan R.O.C
| | - Cheng-Te Chen
- Department of Educational Psychology and Counseling, National Tsing Hua University, Hsin-chu, Taiwan R.O.C
| | - Ching-Hong Tsai
- Department of Child and Adolescent Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kao-hsiung, Taiwan R.O.C
| | - Hsing-Jung Li
- Department of Child and Adolescent Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kao-hsiung, Taiwan R.O.C
| | - Chin-Chin Wu
- Department of Psychology, Kaohsiung Medical University, Kao-hsiung, Taiwan R.O.C
- Department of Medical Research, Kaohsiung Medical University Hospital, Kao-hsiung, Taiwan R.O.C
| | - Chien-Yu Huang
- Department of Occupational Therapy, College of Medicine, I-Shou University, Kao-hsiung, Taiwan R.O.C
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan R.O.C
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan R.O.C
| | - Kuan-Lin Chen
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, No. 1 University Road, Tainan, 701, Taiwan R.O.C..
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan R.O.C..
- Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan R.O.C..
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Gates JA, McNair ML, Richards JK, Lerner MD. Social Knowledge & Performance in Autism: A Critical Review & Recommendations. Clin Child Fam Psychol Rev 2023; 26:665-689. [PMID: 37544969 PMCID: PMC10613329 DOI: 10.1007/s10567-023-00449-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/08/2023]
Abstract
Autistic social challenges have long been assumed to arise from a lack of social knowledge ("not knowing what to do"), which has undergirded theory and practice in assessment, treatment, and education. However, emerging evidence suggests these differences may be better accounted for by difficulties with social performance ("doing what they may know"). This distinction has important implications for research, practice, policy, and community support of autistic people. This review examines the theoretical and clinical implications and empirical status of the knowledge-performance distinction in autism. Current evidence suggests that social knowledge deficits are neither definitional nor reliably related to outcomes in autism. Prioritizing social knowledge, then, may produce unanticipated, problematic consequences in terms of accuracy of assessment, intervention effectiveness, and promotion of stigma. It may also yield unrealistic expectations around the value of knowledge for autistic people and their families, yielding important ethical considerations. Conversely, recent evidence highlights performance-related factors as being especially promising for better modeling and addressing social challenges in autism. Prioritizing performance, then, may offer new directions for assessment, substantially different intervention opportunities, and novel methods of inclusion and affirmation. This review touches upon each of these domains and implications, integrates these developments with broader models of social competence in youth, and provides direction for future research and practice regarding social competence in autism.
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Affiliation(s)
| | | | | | - Matthew D Lerner
- Stony Brook University, Stony Brook, USA.
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA.
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Arnardóttir ÁÁ, Guðmundsdóttir LÁ, Hannesdóttir DK, Halldórsson F, Auðardóttir H, Sveinbjörnsdóttir B. A Pilot Study on the FEST program - Friendship and Emotional Skills Training for Children on the Autism Spectrum. J Autism Dev Disord 2023:10.1007/s10803-023-06099-z. [PMID: 37642875 DOI: 10.1007/s10803-023-06099-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Social skills difficulties among children on the autism spectrum can impede social, emotional, and academic development, especially with increasing age and social demands. This pilot study examined the efficacy of a 5-week skill-building program for children on the autism spectrum. Although effective social skills programs are available for adolescents with autism spectrum disorder (ASD), very few programs are explicitly intended for 10-12-year-old children. METHODS This pilot study examined the efficacy of the 9-session Friendship and Emotional Skills Training (FEST Program) for children with ASD without intellectual disability. Participants were 22 children randomly assigned to the FEST Program or a delayed intervention control group. Eleven children (boys = 8; girls = 3) received the FEST Program in two separate groups, and 11 were wait-listed for a delayed intervention. Parents, teachers, and the children answered questionnaires at baseline, post-intervention, and a 3-month follow-up. RESULTS Upon completing the FEST Program (post-intervention), parents reported an increase in overall social skills (on the Social Skills Rating System - SSRS) and a reduction on the Autistic Mannerisms factor (on the Social Responsiveness Scale - SRS) compared to the control group. These changes were also maintained at the 3-month follow-up. The children's assessment also showed a significant increase in assertion (on the SSRS) post-intervention. Teachers also reported a significant reduction on the Autistic Mannerisms factor at the 3-month follow-up. CONCLUSION The findings suggest that the FEST Program shows some promising results as one possibility for supporting children with ASD and their families in everyday life.
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Affiliation(s)
- Ágústa Á Arnardóttir
- The National Agency for Children and Families (Barna- og fjölskyldustofa), Reykjavik, Iceland.
| | - Laufey Á Guðmundsdóttir
- Children´s Mental Health Center for the Primary Health Care of the Capital Area (Gedheilsumistod barna Heilsugaeslu hofudborgarsvaedisins), Reykjavik, Iceland
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - Dagmar Kr Hannesdóttir
- Children´s Mental Health Center for the Primary Health Care of the Capital Area (Gedheilsumistod barna Heilsugaeslu hofudborgarsvaedisins), Reykjavik, Iceland
- Department of Psychology, University of Iceland, Reykjavik, Iceland
| | - Freyr Halldórsson
- Department of Business Administration, Reykjavik University, Reykjavik, Iceland
| | - Helga Auðardóttir
- SOL clinic - Psychological and medical services for families, Kopavogur, Iceland
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Corbett BA, White S, Lerner M, Preacher KJ, Klemencic ME, Simmons GL, Pilkington J, Gable P, Gioia A, Key AP. Peers, play, and performance to build social salience in autistic youth: A multisite randomized clinical trial. J Consult Clin Psychol 2023; 91:411-425. [PMID: 37199977 PMCID: PMC10330829 DOI: 10.1037/ccp0000821] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Individuals with autism spectrum disorder (ASD) have significant impairment in social competence and reduced social salience. SENSE Theatre, a peer-mediated, theater-based intervention has demonstrated posttreatment gains in face memory and social communication. The multisite randomized clinical trial compared the Experimental (EXP; SENSE Theatre) to an Active Control Condition (ACC; Tackling Teenage Training, TTT) at pretest, posttest, and follow-up. It was hypothesized that the EXP group would demonstrate greater incidental face memory (IFM) and better social behavior (interaction with novel peers) and social functioning (social engagement in daily life) than the ACC group, and posttest IFM would mediate the treatment effect on follow-up social behavior and functioning. METHOD Two hundred ninety participants were randomized to EXP (N = 144) or ACC (N = 146). Per protocol sample (≥ 7/10 sessions) resulted in 207 autistic children 10-16 years. Event-related potentials measured IFM. Naive examiners measured social behavior (Vocal Expressiveness, Quality of Rapport, Social Anxiety) and functioning (Social Communication). Structural equation modeling was used to assess treatment effects. RESULTS SENSE Theatre participants showed significantly better IFM (b = .874, p = .039) at posttest, and significant indirect effects on follow-up Vocal Expressiveness a × b = .064, with 90% CI [.014, .118] and Quality of Rapport a × b = .032, with 90% CI [.002, .087] through posttest IFM. CONCLUSIONS SENSE Theatre increases social salience as reflected by IFM, which in turn affected Vocal Expressiveness and Quality of Rapport. Results indicate that a neural mechanism supporting social cognition and driven by social salience is engaged by the treatment and has a generalized, indirect effect on clinically meaningful functional outcomes related to core symptoms of autism. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Blythe A. Corbett
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center
- Vanderbilt University, Department of Psychology
| | - Susan White
- University of Alabama, Department of Psychology, Tuscaloosa
| | | | | | - Mark E. Klemencic
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences
| | | | - Jennifer Pilkington
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences
| | - Philip Gable
- University of Delaware, Department of Psychological and Brain Sciences
| | - Ayla Gioia
- Stony Brook University, Department of Psychology
| | - Alexandra P. Key
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center
- Vanderbilt University Medical Center, Department of Hearing and Speech Sciences
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Liu G, Chen Y, Ou P, Huang L, Qian Q, Wang Y, He HG, Hu R. Effects of Parent-Child Sandplay Therapy for preschool children with autism spectrum disorder and their mothers: A randomized controlled trial. J Pediatr Nurs 2023; 71:6-13. [PMID: 36947897 DOI: 10.1016/j.pedn.2023.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 02/05/2023] [Accepted: 02/13/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE To evaluate the effects of the Parent-Child Sandplay Therapy (PCST) Program on autism behaviors, social responsiveness and sleep quality among preschool children with autism spectrum disorder (ASD), and their mothers' parenting stress. DESIGN AND METHODS A prospective, randomized controlled, parallel-group trial was employed. Fifty-two child-mother dyads were randomly assigned to an intervention group (n = 26) or a control group (n = 26) from February 2017 to February 2019. The intervention group was treated with a 20-week PCST Program plus an Applied Behavior Analysis-based program (ABA-based program), whereas the control group received only the ABA-based program. Outcome measures included the Autism Behavior Checklist total scores, Social Responsiveness Scale scores, Children's Sleep Habits Questionnaire scores, and Parenting Stress Index-Short Form scores, measured at baseline, post-intervention (20 weeks after baseline) and follow-up assessments (32 weeks after baseline). RESULTS Finally, 43 dyads completed the study. The linear mixed model analysis resulted in a significant group*time interaction effect of ABC score (Est = 2.027, t = 3.277; p < 0.01), SRS score (Est = 3.377, t = 6.095; p < 0.01), PSI-SF score (Est = 3.873, t = 4.253, p < 0.01), and CSHQ score (Est = 3.158, t = 6.485; p < 0.05). CONCLUSION Our findings suggested that the PCST Program could potentially improve social interaction and sleep quality of preschool children with ASD while decreasing parenting stress. PRACTICE IMPLICATIONS The PCST Program was found to be a feasible and a promising treatment for children with mild-to-moderate ASD as well as for their parents. It was a nurse-led program, which could be integrated into the usual nursing care of children with autism spectrum disorder in special education schools. TRIAL REGISTRATION Chinese Clinical Trials Registry, ChiCTR2100047699.
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Affiliation(s)
- Guihua Liu
- Department of Child Health Care, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China; The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Ying Chen
- The School of Nursing, Xiamen Medical College, Xiamen, China
| | - Ping Ou
- Department of Child Health Care, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Longsheng Huang
- Department of Child Health Care, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Qinfang Qian
- Department of Child Health Care, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Yanxia Wang
- Department of Child Health Care, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; National University Health System, Singapore
| | - Rongfang Hu
- The School of Nursing, Fujian Medical University, Fuzhou, China.
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12
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Pronina M, Grofulovic J, Castillo E, Prieto P, Igualada A. Narrative Abilities at Age 3 Are Associated Positively With Gesture Accuracy but Negatively With Gesture Rate. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:951-965. [PMID: 36763840 DOI: 10.1044/2022_jslhr-21-00414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE Though the frequency of gesture use by infants has been related to the development of different language abilities in the initial stages of language acquisition, less is known about whether this frequency (or "gesture rate") continues to correlate with language measures in later stages of language acquisition, or whether the relation to language skills also depends on the accuracy with which such gestures are produced (or reproduced). This study sets out to explore whether preschoolers' narrative abilities are related to these two variables, namely, gesture rate and gesture accuracy. METHOD A total of 31 typically developing 3- to 4-year-old children participated in a multimodal imitation task, a context-based gesture elicitation task, and a narrative retelling task. RESULTS Results showed that there was a significant positive correlation between the children's narrative scores and their gesture accuracy scores, whereas higher rates of gesture use did not correlate with higher levels of narrative skill. Further multimodal regression analysis confirmed that gesture accuracy was a positive predictor of narrative performance, and moreover, showed that gesture rate was a negative predictor. CONCLUSIONS The fact that both gesture accuracy and gesture rate are strongly and differently linked to oral language abilities supports the claim that language and gesture are highly complex systems, and that complementary measures of gesture performance can help us assess with greater granularity the relationship between gesture and language development. These findings highlight the need to use gesture during clinical assessments as an informative indicator of language development and suggest that future research should further investigate the value of multimodal programs in the treatment of language and communication disorders.
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Affiliation(s)
- Mariia Pronina
- Department of Translation and Language Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Eva Castillo
- Department of Translation and Language Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Pilar Prieto
- Department of Translation and Language Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Alfonso Igualada
- Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Barcelona, Spain
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13
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So WC, Cheng CH, Law WW, Wong T, Lee C, Kwok FY, Lee SH, Lam KY. Robot dramas may improve joint attention of Chinese-speaking low-functioning children with autism: stepped wedge trials. Disabil Rehabil Assist Technol 2023; 18:195-204. [PMID: 33186058 DOI: 10.1080/17483107.2020.1841836] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Children with autism spectrum disorder (ASD), especially those with low cognitive functioning, have deficits in joint attention. Previous research has found that these children are interested in engaging with social robots. PURPOSE In the present study, we designed a robot drama intervention for promoting responses to joint attention abilities (RJA) of children with low-functioning autism (IQs < 70). MATERIALS AND METHODS Using a stepped wedge design, Chinese-speaking children aged six to eight were randomly assigned to three tiers (N = 18). Children of all three tiers had comparable autism severity, language and cognitive function, and joint attention abilities. Tier 1 first received intervention, followed by Tiers 2 and 3. They watched six dramas in which social robots demonstrated RJA behaviours. RESULTS The RJA of children of all tiers improved after intervention and such improvement was maintained over time. Despite initiation of joint attention (IJA) not being explicitly taught, IJA of all children was found to improve after intervention. CONCLUSIONS It was, therefore, concluded that a robot drama could enhance the joint attention of children with low-functioning ASD.Implications for rehabilitationIn comparison to typically developing children, children with autism spectrum disorder (ASD), especially those with low cognitive functioning, have deficits in joint attention.Robot-based drama intervention program was developed to promote responses to joint attention (RJA) abilities of children with low-functioning autism (IQs < 70).Modelling RJA in robot dramas can promote RJA abilities in these children.An improvement in RJA also yielded an increase in the initiation of joint attention (IJA) abilities.Children with low-functioning autism might be able to extract the initiation of joint attention skills from the drama, even though these behaviours were not explicitly taught.
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Affiliation(s)
- Wing-Chee So
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Chun-Ho Cheng
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Wing-Wun Law
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Tiffany Wong
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Cassandra Lee
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Fai-Yeung Kwok
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Shing-Hey Lee
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Ka-Yee Lam
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
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14
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Sun J, Okada T. Interaction in acting training and its different manifestations in novice and professional actors. Front Psychol 2023; 13:949209. [PMID: 36698579 PMCID: PMC9869025 DOI: 10.3389/fpsyg.2022.949209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
This study aimed to identify the characteristics of interactions during acting training and the underlying intrapersonal changes evoked by a training process that emphasizes paying attention to a partner (the Meisner technique). This was operationalized by conducting a post-hoc analysis and categorizing the utterances made by novice and professional actors during acting training based on video and audio recordings. In Study 1, novice participants tended to change their way of communication as the course progressed, decreasing the number of utterances that simply described the partner's behavior and increasing those that speculated about the partner's inner state. We then used a different focus placed on the interaction, as implied by the different kinds of utterances used, to describe the divergences between novice and professional actors regarding their interaction characteristics. In Study 2, results showed that while professional actors devoted themselves more to the connection with their partner and demonstrated more balanced communication, novice actors relied on general inference to speculate about others' affective states. By comparing the characteristics of the utterances between novice and professional actors as they played different roles or made switches (i.e., changing from passive to active utterance in communication), this study suggests that an important impact of acting training on social abilities relates to its potential to increase the levels of involvement in on-going interactions.
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Affiliation(s)
- Jingyan Sun
- Department of Interdisciplinary Information Studies, The University of Tokyo, Tokyo, Japan
| | - Takeshi Okada
- Department of Educational Psychology, The University of Tokyo, Tokyo, Japan
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15
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Corbett BA, Muscatello RA, Klemencic ME, West M, Kim A, Strang JF. Greater gender diversity among autistic children by self-report and parent-report. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:158-172. [PMID: 35363085 PMCID: PMC9525458 DOI: 10.1177/13623613221085337] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
LAY ABSTRACT Gender diversity broadly refers to the way in which an individual experiences (expressions and/or identities) their gender distinctly to that which would be expected based upon social norms for their gender assigned at birth. Recent research has shown a higher representation of gender diversity among autistic youth. Previous research in this area has relied on parent-report based on a single question from the Child Behavior Checklist Item-110, asking whether their child "Wishes to be the opposite sex." The Gender Diversity Screening Questionnaire Self-Report and Parent-Report were used to assess the experience of gender diversity in 244 children (140 autism spectrum disorder and 104 typically developing) between 10 and 13 years. The Item-110 was also collected. Results showed that autistic children endorsed much higher rates of Binary Gender Diversity (less identification with their designated sex and more with the other binary sex) and Nonbinary Gender Diversity (identification as neither male nor female) than typically developing children. Similarly, parents of autistic children reported significantly more gender-body incongruence experienced by their child than parents of typically developing children. Specifically, parents of autistic females-assigned-at-birth reported significantly more gender-body incongruence than autistic males-assigned-at-birth. Parent- and self-report measures were largely related. Moreover, statistical comparisons between and within the groups revealed associations between gender profiles and symptoms of anxiety, depression, and suicidality. Results extend previous reports showing increased rates of gender diversity in autistic children, now based on both self-report and parent-report, and highlight the need to better understand and support the unique and complex needs of autistic children who experience gender diversity.
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Affiliation(s)
- Blythe A. Corbett
- Vanderbilt University Medical Center, Department of
Psychiatry and Behavioral Sciences,Vanderbilt Kennedy Center
| | - Rachael A. Muscatello
- Vanderbilt University Medical Center, Department of
Psychiatry and Behavioral Sciences
| | - Mark E. Klemencic
- Vanderbilt University Medical Center, Department of
Psychiatry and Behavioral Sciences
| | - Millicent West
- Vanderbilt University Medical Center, Department of
Psychiatry and Behavioral Sciences
| | - Ahra Kim
- Vanderbilt University Medical Center, Department of
Biostatistics
| | - John F. Strang
- Gender and Autism Program, Children’s National
Hospital,Departments of Pediatrics, Psychiatry, and Behavioral
Science, George Washington University School of Medicine
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16
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Bernier A, Ratcliff K, Hilton C, Fingerhut P, Li CY. Art Interventions for Children With Autism Spectrum Disorder: A Scoping Review. Am J Occup Ther 2022; 76:23901. [PMID: 36007137 DOI: 10.5014/ajot.2022.049320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Autism spectrum disorder (ASD) is a neurological condition characterized by impairments in social interaction, communication, and behavior. Occupational therapy practitioners use creative arts interventions for children with ASD, but relevant evidence for these interventions is lacking. OBJECTIVE To provide occupational therapists evidence of the benefit of creative arts interventions for children with ASD by evaluating treatment efficacy and connecting the evidence with the Occupational Therapy Practice Framework: Domain and Process (4th ed.; OTPF-4). DATA SOURCES We searched peer-reviewed articles in six databases: CINAHL, Cochrane, PubMed, Ovid, PsycInfo, and Scopus. Eighteen articles published between 2000 and 2020 met Level 1b or 2b evidence criteria and were retrieved for full review; 15 were included in this scoping review. STUDY SELECTION AND DATA COLLECTION We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to extract data. Inclusion criteria were as follows: (1) Level 1b or 2b study; (2) quantitative data; (3) published in English; (4) population of children (ages <18 yr); (5) primary diagnosis of ASD; and (6) creative arts intervention in the forms of drawing, painting, or coloring; music; or theater. FINDINGS Creative arts interventions benefited children with ASD in two OTPF-4 areas (process and social interaction) pertaining to the Performance Skills domain and one OTPF-4 area (body functions) pertaining to the Client Factors domain. We found similar effects for group and individual intervention sessions, and significant improvements required multiple sessions. CONCLUSIONS AND RELEVANCE Our findings provide evidence for the efficacy of creative arts interventions to enhance occupation-based outcomes for children with ASD. What This Article Adds: Our findings support occupational therapy practitioners' use of creative arts interventions to improve OTPF-4-based client factors and process and social interaction skills for children with ASD.
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Affiliation(s)
- Allison Bernier
- Allison Bernier is Entry-Level Occupational Therapy Doctoral Student, Department of Occupational Therapy, University of Texas Medical Branch, Galveston
| | - Karen Ratcliff
- Karen Ratcliff, PhD, OTR/L, is Associate Professor, Department of Occupational Therapy, University of Texas Medical Branch, Galveston
| | - Claudia Hilton
- Claudia Hilton, PhD, OTR/L, is Associate Professor, Department of Occupational Therapy, University of Texas Medical Branch, Galveston
| | - Patricia Fingerhut
- Patricia Fingerhut, PhD, OTR/L, is Professor and Chair, Department of Occupational Therapy, University of Texas Medical Branch, Galveston
| | - Chi-Ying Li
- Chi-Ying Li, PhD, OTR/L, is Associate Professor, Department of Occupational Therapy, University of Texas Medical Branch, Galveston;
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17
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McDonald RG, Khawar S, Yacoub N, Cargill MI, Lerner MD, Kang E. Performance- and Theater-Based Interventions for Supporting Social Cognition and Social Communication in Autistic Youth: A Review and Theoretical Synthesis. Semin Speech Lang 2022; 43:255-276. [PMID: 35896405 DOI: 10.1055/s-0042-1750763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Social skills interventions (SSIs) are commonly used to improve social functioning in youth with autism spectrum disorder (ASD), which is a condition characterized by differences in social cognition and social communication. Although more traditional SSIs have used knowledge-based, didactic instruction, recent research has explored the utility of performance-based SSIs, which use various activities to support implicit learning of social skills in supportive, enriched environments. This article reviews the extant literature evaluating the effectiveness or efficacy of five performance-based SSIs using theater-based approaches on social cognition and social communication. Overall, this body of literature suggests social communication gains that include increased peer interactions, peer liking, and reciprocal friendships, as well as social cognitive gains in theory of mind and affect recognition. This review also discusses theoretical models that may help explain the emerging strengths of performance- and theater-based SSIs with underlying hypotheses related to the social communication and social cognitive differences in ASD. Limitations of performance-based SSIs in the evidence-base include several approaches in initial stages of research with small sample sizes and limited maintenance of effects. Future research should aim to bridge the research-to-practice gap and use more rigorous designs and more diverse samples, including those with cooccurring intellectual disability.
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Affiliation(s)
- Rachel G McDonald
- Psychology Department, Montclair State University, Montclair, New Jersey
| | - Sadaf Khawar
- Psychology Department, Montclair State University, Montclair, New Jersey
| | - Nardin Yacoub
- Psychology Department, Montclair State University, Montclair, New Jersey
| | - Mary Isaac Cargill
- Psychology Department, Montclair State University, Montclair, New Jersey
| | - Matthew D Lerner
- Department of Psychology, Stony Brook University, Stony Brook, New York
| | - Erin Kang
- Psychology Department, Montclair State University, Montclair, New Jersey
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18
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Gilmore R, Ziviani J, Chatfield MD, Goodman S, Sakzewski L. Social skills group training in adolescents with disabilities: A systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 125:104218. [PMID: 35306461 DOI: 10.1016/j.ridd.2022.104218] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Group social skills interventions (GSSIs) are offered to youth with Autism Spectrum Disorder (ASD) to improve social functioning. This systematic review focused on the adolescent population, including a wider range of disabilities. AIMS To evaluate effectiveness of GSSIs at improving social functioning in adolescents with congenital, acquired or developmental disabilities. METHODS AND PROCEDURES Databases, trial registries and dissertations were systematically searched and a meta-analysis of randomized controlled trials conducted. Study screening, risk-of-bias assessment and Grading of Recommendations Assessment, Development and Evaluation were completed. OUTCOMES AND RESULTS Sixteen studies (n = 1119), 15 with adolescents with ASD and one with brain tumor survivors, revealed GSSIs reduced social impairment on the Social Responsiveness Scale (mean difference (MD) 9.68, 95% CI 5.63-13.73; P < 0.001), increased social skills on the Social Skill Improvement System Rating Scales (SMD 0.38, 95% CI 0.10-0.65; P = 0.007), and improved adolescent social knowledge on the Test of Adolescent Social Skills (MD 7.43 points, 95% CI 5.36-9.50; P < 0.001). CONCLUSIONS AND IMPLICATIONS There is moderate certainty evidence that GSSIs improve social responsiveness, social skills and knowledge, and low certainty of evidence to improve social participation for adolescents with ASD. High quality randomized studies are required to inform clinical practice with adolescents with other disabilities. WHAT THIS PAPER ADDS Current evidence for group social skills interventions (GSSIs) is for adolescents with autism (ASD). GSSIs likely improve social knowledge and reduce impairments in adolescents with ASD, however the effect of GSSIs on social participation is not well understood. Only one randomized trial investigated GSSIs in another population of adolescents, highlighting the need for more high-quality studies including adolescents with other disabilities.
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Affiliation(s)
- Rose Gilmore
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), Centre for Children's Health Research, Level 6, 62 Graham Street, South Brisbane, Queensland 4101, Australia; Queensland Children's Hospital, 501 Stanley Street, South Brisbane, Queensland 4101, Australia.
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, 4072, Australia
| | - Mark D Chatfield
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), Centre for Children's Health Research, Level 6, 62 Graham Street, South Brisbane, Queensland 4101, Australia
| | - Sarah Goodman
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), Centre for Children's Health Research, Level 6, 62 Graham Street, South Brisbane, Queensland 4101, Australia
| | - Leanne Sakzewski
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), Centre for Children's Health Research, Level 6, 62 Graham Street, South Brisbane, Queensland 4101, Australia
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19
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A Systematic Review of Shared Social Activities for Children on the Autism Spectrum and Their Peers. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00322-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Dramatherapy for Children and Adolescents with Autism Spectrum Disorder: A Systematic Integrative Review. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2022.101918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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21
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Su WC, Amonkar N, Cleffi C, Srinivasan S, Bhat A. Neural Effects of Physical Activity and Movement Interventions in Individuals With Developmental Disabilities-A Systematic Review. Front Psychiatry 2022; 13:794652. [PMID: 35242063 PMCID: PMC8886122 DOI: 10.3389/fpsyt.2022.794652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/03/2022] [Indexed: 01/21/2023] Open
Abstract
Individuals with developmental disabilities present with perceptuo-motor, social communication, and cognitive impairments that often relate to underlying atypical brain structure and functioning. Physical activity/movement interventions improve behavioral performance of individuals with and without developmental disabilities. Majority of the evidence on potential neural mechanisms explaining the impact of physical activity/movement interventions is based on studies in individuals with typical development; there is a dearth of systematic reviews synthesizing the neural effects of physical activity/movement interventions in individuals with developmental disabilities. In this systematic review, we have gathered evidence on the neural effects of physical activity/movement interventions from 32 papers reporting substantial neural effects and behavioral improvements in individuals with developmental disabilities. Chronic intervention effects (multiple sessions) were greater than acute intervention effects (single session). Specifically, using electroencephalogram, functional magnetic resonance imaging, diffusion tensor imaging, and functional near-infrared spectroscopy, studies found physical activity/movement intervention-related changes in neural activity, indicating normalization of cortical arousal in individuals with attention-deficit /hyperactivity disorder (ADHD), increased social brain connectivity in individuals with autism spectrum disorder (ASD), and more efficient executive functioning processes in individuals with a wide range of other developmental disabilities. Despite promising results, more research is clearly needed in this area with larger sample sizes, using standardized neuroimaging tools/variables, and across multiple diagnoses to further explore the neural mechanisms underlying physical activity/movement interventions and to replicate findings from the present review.
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Affiliation(s)
- Wan-Chun Su
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
| | - Nidhi Amonkar
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, United States
| | - Corina Cleffi
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
| | - Sudha Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- Institute for Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, United States
- The Connecticut Institute for the Brain and Cognitive Sciences (IBACS), University of Connecticut, Storrs, CT, United States
| | - Anjana Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
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22
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Vacher C, Romo L, Dereure M, Soler M, Picot MC, Purper-Ouakil D. Efficacy of cognitive behavioral therapy on aggressive behavior in children with attention deficit hyperactivity disorder and emotion dysregulation: study protocol of a randomized controlled trial. Trials 2022; 23:124. [PMID: 35130934 PMCID: PMC8819925 DOI: 10.1186/s13063-022-05996-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is frequently associated with emotional dysregulation (ED). ED is characterized by excessive and inappropriate emotional reactions compared to social norms, uncontrolled and rapid shifts in emotion, and attention focused on emotional stimuli. Few studies have evaluated non-pharmacological interventions to improve ED in children with ADHD. The current randomized controlled trial assesses the efficacy of a cognitive behavioral therapy (CBT) intervention compared with a theater-based intervention (TBI) in children with ADHD and ED. METHODS Sixty-eight 7- to 13-year-old children with ADHD and ED will be recruited and randomly assigned to the CBT or TBI group. CBT aims to reduce ED by teaching anger management strategies. TBI seeks to reduce ED by improving emotion understanding and expression through mimics and movement. In both groups, children participate in 15 1-h sessions, and parents participate in 8 sessions of a parent management program. The primary outcome measure is the change in the "Aggression" sub-score of the Child Behavior Checklist (CBCL). Secondary outcome measures include overall impairment (Children's Global Assessment Scale, Strengths and Difficulties Questionnaire), personality profile (Hierarchical Personality Inventory for Children), executive function (Behavioral Rating Inventory of Executive Function), quality of life (Kidscreen-27), parental stress (Parenting Stress Index, 4th edition), parental depression (Beck Depression Inventory-II), and impact of child disorders on the quality of the family life (Parental Quality of Life and Developmental Disorder). DISCUSSION Children with ADHD and ED are at risk of functional impairment and poor outcomes and have specific therapeutic needs. This randomized controlled trial wants to assess non-pharmacological treatment options for this population. TRIAL REGISTRATION Clinicaltrials.gov. NCT03176108 . Registered on June 5, 2017.
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Affiliation(s)
- C Vacher
- Centre Hospitalo-Universitaire de Montpellier, Service Médecine Psychologique de l'Enfant et de l'Adolescent, Montpellier, Hérault, France. .,CLIPSYD EA-4430, UFR Sciences Psychologiques et Sciences de l'Education, Université de Nanterre, Nanterre, Hauts de Seine, France. .,INSERM U 1018, CESP, Psychiatrie du développement - Evaluer et traiter les troubles émotionnels et du neurodéveloppement (ETE-ND), Montpellier, France.
| | - L Romo
- CLIPSYD EA-4430, UFR Sciences Psychologiques et Sciences de l'Education, Université de Nanterre, Nanterre, Hauts de Seine, France.,Service de Pathologies professionnelles et de l'environnement, Assistance Publique des Hôpitaux de Paris, Hôpital Universitaire Raymond Poincaré, Garches, France
| | - M Dereure
- Unité de Recherche Clinique et Epidémiologie, Département de l'Information Médicale, Centre Hospitalo-Universitaire de Montpellier, Montpellier, Hérault, France
| | - M Soler
- Unité de Recherche Clinique et Epidémiologie, Département de l'Information Médicale, Centre Hospitalo-Universitaire de Montpellier, Montpellier, Hérault, France
| | - M C Picot
- Unité de Recherche Clinique et Epidémiologie, Département de l'Information Médicale, Centre Hospitalo-Universitaire de Montpellier, Montpellier, Hérault, France.,Centre d'Investigation Clinique, Hôpital Saint Eloi, Centre Hospitalo-Universitaire de Montpellier, Montpellier, Hérault, France
| | - D Purper-Ouakil
- Centre Hospitalo-Universitaire de Montpellier, Service Médecine Psychologique de l'Enfant et de l'Adolescent, Montpellier, Hérault, France.,INSERM U 1018, CESP, Psychiatrie du développement - Evaluer et traiter les troubles émotionnels et du neurodéveloppement (ETE-ND), Montpellier, France
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23
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Key AP. Searching for a "Brain Signature" of Neurodevelopmental Disorders: Event-Related Potentials and the Quest for Biomarkers of Cognition. J Clin Neurophysiol 2022; 39:113-120. [PMID: 34366396 DOI: 10.1097/wnp.0000000000000727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SUMMARY This review summarizes main applications of event-related potentials (ERPs) to the study of cognitive processes in persons with neurodevelopmental disorders, for whom traditional behavioral assessments may not be suitable. A brief introduction to the ERPs is followed by a review of empirical studies using passive ERP paradigms to address three main questions: characterizing individual differences, predicting risk for poor developmental outcomes, and documenting treatment effects in persons with neurodevelopmental disorders. Evidence across studies reveals feasibility of ERP methodology in a wide range of clinical populations and notes consistently stronger brain-behavior associations involving ERP measures of higher-order cognition compared with sensory-perceptual processes. The final section describes the current limitations of ERP methodology that need to be addressed before it could be used as a clinical tool and highlights the needed steps toward translating ERPs from group-level research applications to individually interpretable clinical use.
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Affiliation(s)
- Alexandra P Key
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, Tennessee, U.S.A
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24
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Amonkar N, Su WC, Bhat AN, Srinivasan SM. Effects of Creative Movement Therapies on Social Communication, Behavioral-Affective, Sensorimotor, Cognitive, and Functional Participation Skills of Individuals With Autism Spectrum Disorder: A Systematic Review. Front Psychiatry 2021; 12:722874. [PMID: 34867515 PMCID: PMC8637167 DOI: 10.3389/fpsyt.2021.722874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder affecting multiple developmental domains including social communication, behavioral-affective, sensorimotor, and cognitive systems. There is growing evidence for the use of holistic, whole-body, Creative Movement Therapies (CMT) such as music, dance, yoga, theater, and martial arts in addressing the multisystem impairments in ASD. We conducted a comprehensive quantitative and qualitative review of the evidence to date on the effects of CMT on multiple systems in individuals with ASD. The strongest evidence, both in terms of quantity and quality, exists for music and martial arts-based interventions followed by yoga and theater, with very limited research on dance-based approaches. Our review of 72 studies (N = 1,939 participants) across participants with ASD ranging from 3 to 65 years of age suggests that at present there is consistent evidence from high quality studies for small-to-large sized improvements in social communication skills following music and martial arts therapies and medium-to-large improvements in motor and cognitive skills following yoga and martial arts training, with insufficient evidence to date for gains in affective, sensory, and functional participation domains following CMT. Although promising, our review serves as a call for more rigorous high-quality research to assess the multisystem effects of CMT in ASD. Based on the existing literature, we discuss implications of our findings for autism researchers and also provide evidence-based guidelines for clinicians to incorporate CMT approaches in their plan of care for individuals with ASD.
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Affiliation(s)
- Nidhi Amonkar
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- Institute for Health, Intervention, and Policy, University of Connecticut, Storrs, CT, United States
- The Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs, CT, United States
| | - Wan-Chun Su
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
| | - Anjana N. Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
| | - Sudha M. Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- Institute for Health, Intervention, and Policy, University of Connecticut, Storrs, CT, United States
- The Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs, CT, United States
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25
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Bailey B, Zyga O, Meeker H, Kirk J, Russ SW. A comparison of curricula: Examining the efficacy of a school-based musical theater intervention. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 25:370-386. [PMID: 31750754 DOI: 10.1177/1744629519883159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Students qualifying for services under the Individuals with Disabilities Education Act may experience challenges meeting the socioemotional demands of the school environment, creating a need for targeted interventions that can be delivered within school settings. The current study used a mixed-methods approach to examine the efficacy of a 4-week school-based musical theater intervention delivered to 121 elementary students with intellectual and developmental disabilities. Quantitative analyses of teacher-reported changes in student engagement pre- and post-intervention were conducted to compare student gains made across two intervention curricula, followed by qualitative content analyses of teachers' responses to open-ended survey questions. Results indicated an overall benefit of the musical theater intervention, with increases found in composite scores on the teacher-report Student Engagement Survey measure after completion of both intervention curricula; however, gains in individual survey item scores differed by curricula. Additionally, qualitative analyses provided positive insight into several aspects of the intervention.
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Affiliation(s)
| | - Olena Zyga
- 2546Case Western Reserve University, USA
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26
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Can I Learn to Play? Randomized Control Trial to Assess Effectiveness of a Peer-Mediated Intervention to Improve Play in Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 51:1823-1838. [PMID: 32870416 DOI: 10.1007/s10803-020-04671-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Play is often used in interventions to improve social outcomes for children with autism spectrum disorders (ASD). Play is a primary occupation of childhood and, therefore, an important outcome of intervention. The Ultimate Guide to Play, Language and Friendship (PLF) is a peer-mediated intervention for 6-11-year-old children with ASD. A total of 68 dyads were randomized to either a 10-week treatment first or waitlist control group. Results revealed a significant moderate intervention effect from pre- to post-intervention, which was maintained to the 3-month follow-up clinic session and generalized to the home environment. The findings support that the PLF intervention can be used to positively improve play in 6-11-year-old children with ASD.Australian New Zealand Clinical Trials Registry, https://www.anzctr.org.au/ (ACTRN12615000008527; Universal Trial Number: U1111-1165-2708).
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27
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Schmidt I, Rutanen T, Luciani RS, Jola C. Feeling for the Other With Ease: Prospective Actors Show High Levels of Emotion Recognition and Report Above Average Empathic Concern, but Do Not Experience Strong Distress. Front Psychol 2021; 12:543846. [PMID: 34140906 PMCID: PMC8203906 DOI: 10.3389/fpsyg.2021.543846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/03/2021] [Indexed: 12/20/2022] Open
Abstract
Differences in empathic abilities between acting, dance, and psychology students were explored, in addition to the appropriateness of existing empathy measures in the context of these cohorts. Students (N = 176) across Higher Education Institutions in the United Kingdom and Europe were included in the online survey analysis, consisting of the Reading the Mind in the Eyes (RME) test, the Interpersonal Reactivity Index (IRI), the Empathy Quotient (EQ), and the E-drawing test (EDT), each measuring particular facets of empathy. Based on existing evidence and our understanding of the discipline practices, we predicted that acting students would perform the best at identifying people’s emotional expressions but might lack other cognitive or affective empathy skills, particularly those related to emotional reactions. This cohort thus provides an opportunity to evaluate different empathy measures. While actors showed significantly higher RME scores than dancers, the difference between actors and psychologists was marginal. Moreover, actors’ scores did not differ significantly on other empathy measures, such as their concern for others’ emotional wellbeing or fantasy, both measured by IRI subscales. Psychology students scored highest in the IRI perspective taking subscale and the data supported anecdotal evidence that psychologists were more concerned for others’ emotional wellbeing than dancers or actors. Dancers seemed the least concerned with others’ perspectives and emotional states, which we explained through a somatosensory ‘inward’ focus required by their art form. Nevertheless, compared to the general population, our groups reported higher empathic abilities on all IRI subscales except for personal distress. Altogether, our study shows that the RME, the IRI, and the EDT vary in their susceptibility to different facets of empathic abilities in acting, dance, and psychology students whereas the EQ does not. Emotions can be expressed and perceived through language, facial expressions, or behavior. As many empathy tests focus on one type of signal they might miss other strategies. Where empathy tests are applied to individuals that have a predominance to read or respond to others in a particular way, as we showed through these three disciplines, they might not capture these empathic strategies. We thus propose that empathy tests must evolve by means of integrating varied forms of communication.
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Affiliation(s)
- Isabell Schmidt
- Division of Psychology and Forensic Sciences, School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Tuomas Rutanen
- Division of Psychology and Forensic Sciences, School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Roberto S Luciani
- Division of Psychology and Forensic Sciences, School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Corinne Jola
- Division of Psychology and Forensic Sciences, School of Applied Sciences, Abertay University, Dundee, United Kingdom
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28
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Mazzoli E, Salmon J, Pesce C, Teo WP, Rinehart N, May T, Barnett LM. Effects of classroom-based active breaks on cognition, sitting and on-task behaviour in children with intellectual disability: a pilot study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:464-488. [PMID: 33719112 DOI: 10.1111/jir.12826] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Classroom-based active breaks can help typically developing children reduce sitting, increase physical activity and improve cognitive functions and on-task behaviour. Yet, this strategy has not been tested in children with intellectual disability (ID) - a population who are insufficiently active. This study aimed to investigate the effects of a 5-week active breaks intervention on cognitive functions and on-task behaviour in schoolchildren with ID. METHODS Twenty-four children, aged between 8 and 12 years (37.5% girls), were recruited. Children's cognitive functions (response inhibition, lapses of attention, interference and working memory) were measured at baseline and end of trial using computer-based tests. Sitting, standing and movement patterns were assessed with inclinometers, and on-task behaviour was directly observed in the classroom before and after active breaks, at baseline, mid-trial and end of trial. Linear mixed models were used to investigate the intervention effects on cognitive functions and sedentary patterns; generalised linear mixed models were used to analyse on-task behaviour data. RESULTS A significant time × group interaction was found for working memory favouring the intervention (B = 11.56, 95% confidence interval [1.92, 21.21]). No significant effects were found in relation to the other measures of children's cognition or on-task behaviour. Stepping time and bouts of sitting were positively affected. CONCLUSIONS Classroom-based active breaks can increase physical activity and reduce sedentary behaviour in children with ID and might also benefit their working memory. Further research is required to clarify the effects on cognition and to investigate whether this strategy has other benefits in this population.
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Affiliation(s)
- E Mazzoli
- Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - J Salmon
- Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - C Pesce
- Department of Movement, Human and Health Sciences, University of Rome 'Foro Italico', Rome, Italy
| | - W-P Teo
- Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Physical Education and Sports Science (PESS) Academic Group, National Institute of Education (NIE), Nanyang Technological University, Singapore
| | - N Rinehart
- Deakin Child Study Centre, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - T May
- Department of Paediatrics, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - L M Barnett
- Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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29
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Su WC, Srinivasan S, Cleffi C, Bhat A. Short report on research trends during the COVID-19 pandemic and use of telehealth interventions and remote brain research in children with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1816-1822. [PMID: 33836625 DOI: 10.1177/13623613211004795] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT The COVID-19 pandemic has caused disruption in F2F healthcare delivery and neuroimaging research, especially when involving vulnerable populations such as children with autism spectrum disorder. Given the easy access to multiple video conferencing platforms, many healthcare services have moved to an online delivery format (i.e. telehealth). It is important to monitor the behavioral and neural effects of telehealth interventions and resume neuroimaging research while adopting public health safety protocols to control the risk of COVID-19 transmission. We summarize existing safety protocols and our own experience from in-person functional near-infrared spectroscopy neuroimaging data collection (on-site, at home, and in outdoor settings), as well as potential opportunities of using online data sharing and low-cost, remote neuroimaging/electrophysiological techniques to continue brain research during the pandemic.
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30
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Vilà-Giménez I, Prieto P. The Value of Non-Referential Gestures: A Systematic Review of Their Cognitive and Linguistic Effects in Children's Language Development. CHILDREN (BASEL, SWITZERLAND) 2021; 8:148. [PMID: 33671119 PMCID: PMC7922730 DOI: 10.3390/children8020148] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 12/04/2022]
Abstract
Speakers produce both referential gestures, which depict properties of a referent, and non-referential gestures, which lack semantic content. While a large number of studies have demonstrated the cognitive and linguistic benefits of referential gestures as well as their precursor and predictive role in both typically developing (TD) and non-TD children, less is known about non-referential gestures in cognitive and complex linguistic domains, such as narrative development. This paper is a systematic review and narrative synthesis of the research concerned with assessing the effects of non-referential gestures in such domains. A search of the literature turned up 11 studies, collectively involving 898 2- to 8-year-old TD children. Although they yielded contradictory evidence, pointing to the need for further investigations, the results of the six studies-in which experimental tasks and materials were pragmatically based-revealed that non-referential gestures not only enhance information recall and narrative comprehension but also act as predictors and causal mechanisms for narrative performance. This suggests that their bootstrapping role in language development is due to the fact that they have important discourse-pragmatic functions that help frame discourse. These findings should be of particular interest to teachers and future studies could extend their impact to non-TD children.
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Affiliation(s)
- Ingrid Vilà-Giménez
- Department of Translation and Language Sciences, Universitat Pompeu Fabra, 08018 Barcelona, Spain;
- Department of Subject-Specific Education, Universitat de Girona, 17004 Girona, Spain
| | - Pilar Prieto
- Department of Translation and Language Sciences, Universitat Pompeu Fabra, 08018 Barcelona, Spain;
- Institució Catalana de Recerca i Estudis Avançats (ICREA), 08010 Barcelona, Spain
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31
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Randomized Controlled Trial of a Video Gaming-Based Social Skills Program for Children on the Autism Spectrum. J Autism Dev Disord 2021; 51:3637-3650. [PMID: 33389304 PMCID: PMC7778851 DOI: 10.1007/s10803-020-04801-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 11/21/2022]
Abstract
Families often face financial and geographical barriers to services for children with autism. The current study explored the effectiveness of a parent-supported adaptation of the computer game-based social skills program Secret Agent Society (SAS). Seventy child-parent dyads were randomized to SAS (n = 35) or a caregiver-supported cognitive skills training game (CIA—control comparison; n = 35), both completed over 10 weeks. Child participants were on the autism spectrum and aged seven to 12 years (60 boys, 10 girls). SAS participants improved more than CIA participants on parent-rated social skills and problem behaviors and teacher-rated social skills. Findings suggest the intervention may be a convenient, cost-effective therapeutic approach, especially during times of restricted face-to-face service access, such as COVID-19.
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Corbett BA, Schwartzman JM, Libsack EJ, Muscatello RA, Lerner MD, Simmons GL, White SW. Camouflaging in Autism: Examining Sex-Based and Compensatory Models in Social Cognition and Communication. Autism Res 2021; 14:127-142. [PMID: 33220170 PMCID: PMC7986572 DOI: 10.1002/aur.2440] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/16/2020] [Accepted: 11/09/2020] [Indexed: 12/20/2022]
Abstract
Camouflaging refers to behavioral adaptations that individuals with autism spectrum disorder (ASD), especially females, use to mask symptoms during social situations. Compensation is a component of camouflaging in which an individual's observed behavior is considerably better than actual ability. The study explored diagnostic, sex-based, and compensatory differences using the Contextual Assessment of Social Skills (CASS). The sample included 161 youth 10:0-to-16:11 years (115 males, 46 females). T-tests were performed based on sex (female, male) or High (good ADOS + poor Theory of Mind (TOM)) compared to Low (poor ADOS + poor TOM) Compensation groups. Comparisons were examined for Social Affect (SA), Restricted Repetitive Behavior, (RRB), IQ, social behavior (Positive Affect, Overall Involvement) and communication (Vocal Expression, Gestures). Females exhibited fewer RRB t(158) = 3.05, P = 0.003, d = 0.54. For the CASS, females evidenced more Vocal Expressiveness t(157) = -2.03, P = 0.05, d = 0.35, which corroborates sex-based differences in the literature. Compensation group differences indicated the High compared to Low group showed stronger Social and Communication behaviors on the CASS for Vocal Expression t(72) = 2.56, P = 0.01, d = 0.62, and overall rapport t(72) = 2.36, P = 0.02, d = 0.56. Several differences were observed when the groups were stratified based on level of compensation, with the High compensation participants showing stronger social engagement and communication behaviors. Findings may inform efforts to understand camouflaging, compensation, and clinical practices for male and female adolescents with ASD. A more nuanced consideration of camouflaging alongside compensation models reveals subtle differences in cognition, behavior, and affect that may reflect underlying profiles of challenge and strength in youth with ASD. LAY SUMMARY: Camouflaging refers to ways individuals with autism spectrum disorder (ASD), especially females, mask symptoms. Compensation occurs when a person's observed behavior appears more typical than what would be expected based on underlying ability and symptoms. The study explored camouflaging and compensation differences in 161 youth with ASD. Findings suggest sex-based differences with females showing better vocal expression. However, several compensation differences were observed with the High compensators showing stronger social communication and rapport. A more nuanced consideration of camouflaging using compensation models reveal subtle differences in underlying challenge and strength.
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33
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Filmmaking and video as therapeutic tools: Case studies on autism spectrum disorder. ARTS IN PSYCHOTHERAPY 2020. [DOI: 10.1016/j.aip.2020.101714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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34
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Simmons GL, Ioannou S, Smith JV, Corbett BA, Lerner MD, White SW. Utility of an Observational Social Skill Assessment as a Measure of Social Cognition in Autism. Autism Res 2020; 14:709-719. [PMID: 33034159 DOI: 10.1002/aur.2404] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 08/03/2020] [Accepted: 09/18/2020] [Indexed: 12/13/2022]
Abstract
Models of impaired social competence in autism spectrum disorder (ASD) highlight deficits in social cognition and social behavior. The Contextual Assessment of Social Skills (CASS) is a laboratory-based assessment of conversation ability in which participants interact with trained confederates who act interested (CASS-I) and bored (CASS-B), sequentially. The increased ecological validity of the CASS allows for better generalization to real-world social situations. Participants' perceptions of confederate behavior, assessed by the CASS Conversation Rating Scale (CRS), might offer additional utility as a metric of social cognition. The current study examined CASS confederate behavior (adherence to interested or bored condition) and both internal validity and convergent validity of the CASS as a measure of social behavior and social cognition. Fifty adolescents with ASD participated as part of a multisite randomized clinical trial. Adherence ratings were consistent across gender and site, with interested confederates significantly out-performing bored confederates. The ability to distinguish between interested and bored confederates was positively associated with CASS social behavior and social cognition tasks, although social behavior during the CASS was not consistently associated with parent-rated social behavior. Controlling for confederate behavior did not significantly alter these associations. Findings demonstrate strong internal validity of the CASS and, partially, external validity of the CASS as a measure of social cognition. Findings highlight nuanced differences in social behavior and social cognition. The CASS shows promise as an outcome measure for clinical interventions and should be incorporated into a multimethod battery to assess social competence in individuals with ASD. LAY SUMMARY: Social cognition and social behavior should be studied together to examine social competence in youth with autism. The Contextual Assessment of Social Skills (CASS), a behavioral observation measure, shows promise toward this end; findings suggest the CASS taps social cognition and social behavior when administered alongside a participant rating scale of their conversation partner's engagement. Continued research, including examination of the CASS, may inform best practices in comprehensive assessment of social competence in autism. Autism Res 2021, 14: 709-719. © 2020 International Society for Autism Research and Wiley Periodicals LLC.
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Affiliation(s)
- Grace Lee Simmons
- Department of Psychology, Center for Youth Development and Intervention, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Sara Ioannou
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jessica V Smith
- Department of Psychology, Center for Youth Development and Intervention, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Matthew D Lerner
- Clinical Psychology, Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Susan W White
- Department of Psychology, Center for Youth Development and Intervention, The University of Alabama, Tuscaloosa, Alabama, USA
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Grzadzinski R, Janvier D, Kim SH. Recent Developments in Treatment Outcome Measures for Young Children With Autism Spectrum Disorder (ASD). Semin Pediatr Neurol 2020; 34:100806. [PMID: 32446440 PMCID: PMC7248125 DOI: 10.1016/j.spen.2020.100806] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Significant advancements have been made in early intervention programs for children with Autism spectrum disorder (ASD). However, measuring treatment response for children with ASD is difficult due to the heterogeneity of changes in symptoms, which can be subtle, especially over a short period of time. Here we outline the challenge of evaluating treatment response with currently available measures as well as newly developed or refined measures that may be useful in clinical trials for young children with ASD. Continued development of treatment outcome measures will help the field identify and compare efficacious interventions and tailor treatments for children with ASD.
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Affiliation(s)
- Rebecca Grzadzinski
- University of North Carolina, Carolina Institute for Developmental Disabilities, Chapel Hill, NC.
| | - Denisse Janvier
- Center for Autism and the Developing Brain, Weill Cornell Medical College, New York-Presbyterian Hospital, White Plains, NY
| | - So Hyun Kim
- Center for Autism and the Developing Brain, Weill Cornell Medical College, New York-Presbyterian Hospital, White Plains, NY
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36
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Perryman T, Ricks L, Cash-Baskett L. Meaningful Transitions: Enhancing Clinician Roles in Transition Planning for Adolescents With Autism Spectrum Disorders. Lang Speech Hear Serv Sch 2020; 51:899-913. [PMID: 32585119 DOI: 10.1044/2020_lshss-19-00048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose The purpose of this tutorial is to provide speech-language pathologists (SLPs) with foundational information that will assist them in transition planning for students with autism spectrum disorder (ASD) based on a review of current literature. SLPs must be knowledgeable of transition planning in order to assist students with ASD and their families with preparing for their future. An appreciation and awareness of pertinent assessments, functional goals, and factors associated with successful postsecondary outcomes are essential competencies that SLPs need when planning for the transition process. SLPs are ideal workforce development partners. They facilitate independence, communication, and interaction skills necessary for postsecondary and workplace success. Speech-language services are one of the most common special education services received by high school students with Individualized Education Programs. However, SLPs receive little preparation on the specifics or nuances of transition planning prior to working in the educational settings, despite the high incidence of speech-language services in secondary education. Method This tutorial reviews and synthesizes research findings related to assessment planning, goal-setting, and Individualized Education Program implementation for achieving meaningful postsecondary transitions for students with ASD. Additionally, it highlights some of the key postsecondary skillsets related to speech-language therapy services, including the development of self-determination, self-advocacy, social competence, and adaptive behaviors. Conclusion Greater focus on higher quality transition planning requires SLPs to develop high levels of knowledge and competencies in the transition planning process. This tutorial educates clinicians on the unique challenges faced by individuals with ASD and provides evidence-based strategies to help students and families successfully plan for and navigate postsecondary transitions.
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Affiliation(s)
- Twyla Perryman
- Department of Communication Sciences and Professional Counseling, University of West Georgia, Carrollton
| | - Lacey Ricks
- Department for Counselor Education and Family Studies, Liberty University, Lynchburg, VA
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Ioannou S, Key AP, Muscatello RA, Klemencic M, Corbett BA. Peer Actors and Theater Techniques Play Pivotal Roles in Improving Social Play and Anxiety for Children With Autism. Front Psychol 2020; 11:908. [PMID: 32536887 PMCID: PMC7269006 DOI: 10.3389/fpsyg.2020.00908] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/14/2020] [Indexed: 12/23/2022] Open
Abstract
Children with autism spectrum disorder (ASD) have significant difficulty in social functioning to include engaging in natural play with peers. Many children with ASD exhibit significantly less interactive play and more physiological stress during benign social encounters with same-age peers on a playground. Theatrical role-playing and performance with expert role models may provide a unique opportunity for children with ASD to learn to engage with other children in a safe, supportive environment. SENSE Theatre® is a peer-mediated, theater-based program aimed at improving social competence in youth with ASD. Previous studies have shown significant improvements in social and communication skills following SENSE Theatre® intervention. The current project examined play with novel peers and self-reported anxiety before and after participation in SENSE Theatre®. Participants included 77 children between 8 and 16 years with high-functioning (IQ ≥ 70) ASD. The combined sample of three cohorts was randomized to the experimental (EXP, N = 44) or waitlist control (WLC, N = 33) group. Participants in the EXP group received 40 h (10, 4-h sessions) of SENSE Theatre®. The Peer Interaction Paradigm (PIP), an ecologically valid measure of natural play, was administered before and after the intervention. Group Play and Self Play on the playground equipment during solicited (T4) and unsolicited (T1) play were used in the current study. The State Trait Anxiety Scale for Children (STAIC; Spielberger et al., 1983) was used to measure self-reported current and persistent anxiety, respectively. Following treatment, children in the EXP group engaged in significantly more Group Play with novel peers [F(2,73) = 7.78, p = 0.007] and much less Self Play [F(2,73) = 6.70, p = 0.01] during solicited play compared to the WLC group. Regression analysis revealed that pretreatment play and group status were significant predictors of solicited Group Play. Children in the EXP group reported significantly less Trait anxiety following intervention [F(2,71) = 6.87, p = 0.01]; however, State anxiety was comparable. Results corroborate previous findings of significant changes in social and play behavior in children with ASD following the peer-mediated, theater-based intervention. Acting and theatrical performance with supportive role models facilitates social engagement in everyday settings with novel peers and reductions in self-reported anxiety.
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Affiliation(s)
- Sara Ioannou
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Alexandra P. Key
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | | | - Mark Klemencic
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Blythe A. Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Psychology, Vanderbilt University, Nashville, TN, United States
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38
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Thomas BR, Charlop MH, Lim N, Gumaer C. Effects of socially appropriate singing on the vocal stereotypy of children with autism spectrum disorder. BEHAVIORAL INTERVENTIONS 2020. [DOI: 10.1002/bin.1709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Benjamin R. Thomas
- Division of Behavioral and Organizational SciencesClaremont Graduate University Claremont California
| | | | - Nataly Lim
- Department of PsychologyClaremont McKenna College Claremont California
| | - Caitlyn Gumaer
- Division of Behavioral and Organizational SciencesClaremont Graduate University Claremont California
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Thompson C, McDonald J, Kidd T, Falkmer T, Bölte S, Girdler S. "I don't want to be a patient": Peer mentoring partnership fosters communication for autistic university students. Scand J Occup Ther 2020; 27:625-640. [PMID: 32180486 DOI: 10.1080/11038128.2020.1738545] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: Despite recognition of the benefits of post-school education in improving life outcomes for autistic adults their university completion rates remain low.Aim: To explore the experiences of undergraduate autistic university students participating in specialist peer mentoring (SPM) to identify active ingredients in the peer mentoring process and to examine the impact of SPM on social communication.Material and method: A total of 30 (8 female; M age = 22.3; SD = 6.7) undergraduate autistic university students engaged in SPM participated in this study. A quantitative pre-test post-test design examined changes in autistic traits. In parallel, the experiences of participating in SPM were explored through semi-structured interviews.Results: Improvements were noted at post-test on the Social Responsiveness Scale-2 total score p = 0.02), and its Social Communication, (p = 0.03) and Social Motivation (p = 0.03) sub-scales. Four themes emerged from the interviews: Developing Partnership and Understanding, Modelling and Practising Communication, Psychological Support and Grading and Planning Skills.Conclusions: These results indicated that the mentor-mentee partnership was a crucial active ingredient of SPM. This partnership appeared to modify social cognition and motivation for autistic university students through modelling and practising communication.Significance: These results demonstrate that SPM can support participation at university for autistic university students.
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Affiliation(s)
- C Thompson
- Cooperative Research Centre for Living with Autism (Autism CRC), Perth, Australia.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - J McDonald
- Counselling and Disability Services, Curtin University, Perth, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - T Kidd
- School of Psychology, Curtin University, Perth, Australia.,Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - T Falkmer
- Cooperative Research Centre for Living with Autism (Autism CRC), Perth, Australia.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.,Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - S Bölte
- Cooperative Research Centre for Living with Autism (Autism CRC), Perth, Australia.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.,Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet and Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - S Girdler
- Cooperative Research Centre for Living with Autism (Autism CRC), Perth, Australia.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
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40
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Afsharnejad B, Falkmer M, Black MH, Alach T, Lenhard F, Fridell A, Coco C, Milne K, Chen NTM, Bölte S, Girdler S. KONTAKT© for Australian adolescents on the autism spectrum: protocol of a randomized control trial. Trials 2019; 20:687. [PMID: 31815642 PMCID: PMC6902510 DOI: 10.1186/s13063-019-3721-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 09/13/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Individuals diagnosed with autism spectrum disorder (ASD) experience impairing challenges in social communication and interaction across multiple contexts. While social skills group training (SSGT) has shown moderate effects on various sociability outcomes in ASD, there is a need for (1) replication of effects in additional clinical and cultural contexts, (2) designs that employ active control groups, (3) calculation of health economic benefits, (4) identification of the optimal training duration, and (5) measurement of individual goals and quality of life outcomes. METHOD/DESIGN With the aim of investigating the efficacy and cost-effectiveness of a SSGT, KONTAKT©, a two-armed randomized control trial with adolescents aged 12-17 years (N = 90) with ASD and an intelligence quotient (IQ) of over 70 will be undertaken. Following stratification for centre and gender, participants will be randomly assigned to either KONTAKT© or to an active control group, a group-based cooking programme. Participants will attend both programmes in groups of 6-8 adolescents, over 16 one-and-a-half-hour sessions. The primary outcome examined is adolescent self-rated achievement of personally meaningful social goals as assessed via the Goal Attainment Scaling during an interview with a blinded clinician. Secondary outcomes include adolescent self-reported interpersonal efficacy, quality of life, social anxiety, loneliness, face emotion recognition performance and associated gaze behaviour, and parent proxy reports of autistic traits, quality of life, social functioning, and emotion recognition and expression. Cost-effectiveness will be investigated in relation to direct and indirect societal and healthcare costs. DISCUSSION The primary outcomes of this study will be evidenced in the anticipated achievement of adolescents' personally meaningful social goals following participation in KONTAKT© as compared to the active control group. This design will enable rigorous evaluation of the efficacy of KONTAKT©, exercising control over the possibly confounding effect of exposure to a social context of peers with a diagnosis of ASD. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12617001117303. Registered on 31 July 2017. anzctr.org.au ClinicalTrials.gov, NCT03294668. Registered on 22 September 2017. https://clinicaltrials.gov.
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Affiliation(s)
- Bahareh Afsharnejad
- School of Occupational Therapy, Social Works and Speech pathology, Curtin University, Kent street, Bentley, Perth, WA 6102 Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA Australia
| | - Marita Falkmer
- School of Occupational Therapy, Social Works and Speech pathology, Curtin University, Kent street, Bentley, Perth, WA 6102 Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA Australia
- CHILD, Swedish Institute for Disability Research, School of Education and Communication, Jönköping University, Gjuterigatan, Sweden
| | - Melissa H. Black
- School of Occupational Therapy, Social Works and Speech pathology, Curtin University, Kent street, Bentley, Perth, WA 6102 Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA Australia
| | - Tasha Alach
- Autism Association of Western Australia, Perth, WA Australia
| | - Fabian Lenhard
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Division of Neuropsychiatry, Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Anna Fridell
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Division of Neuropsychiatry, Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Christina Coco
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Division of Neuropsychiatry, Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Kelly Milne
- Autism Association of Western Australia, Perth, WA Australia
| | - Nigel T. M. Chen
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA Australia
| | - Sven Bölte
- School of Occupational Therapy, Social Works and Speech pathology, Curtin University, Kent street, Bentley, Perth, WA 6102 Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA Australia
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Division of Neuropsychiatry, Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Sonya Girdler
- School of Occupational Therapy, Social Works and Speech pathology, Curtin University, Kent street, Bentley, Perth, WA 6102 Australia
- Curtin Autism Research Group (CARG), Curtin University, Perth, WA Australia
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41
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Naveed S, Waqas A, Amray AN, Memon RI, Javed N, Tahir MA, Ghozy S, Jahan N, Khan AS, Rahman A. Implementation and effectiveness of non-specialist mediated interventions for children with Autism Spectrum Disorder: A systematic review and meta-analysis. PLoS One 2019; 14:e0224362. [PMID: 31703073 PMCID: PMC6839885 DOI: 10.1371/journal.pone.0224362] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 10/13/2019] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION In recent years, several non-specialist mediated interventions have been developed and tested to address problematic symptoms associated with autism. These can be implemented with a fraction of cost required for specialist delivered interventions. This review represents a robust evidence of clinical effectiveness of these interventions in improving the social, motor and communication deficits among children with autism. METHODS An electronic search was conducted in eight academic databases from their inception to 31st December 2018. A total of 31 randomized controlled trials were published post-2010 while only 2 were published prior to it. Outcomes pertaining to communication, social skills and caregiver-child relationship were meta-analyzed when reported in > 2 studies. RESULTS A significant improvement was noted in child distress (SMD = 0.55), communication (SMD = 0.23), expressive language (SMD = 0.47), joint engagement (SMD = 0.63), motor skills (SMD = 0.25), parental distress (SMD = 0.33) parental self-efficacy (SMD = 0.42) parent-child relationship (SMD = 0.67) repetitive behaviors (SMD = 0.33), self-regulation (SMD = 0.54), social skills (SMD = 0.53) symptom severity (SMD = 0.44) and visual reception (SMD = 0.29). CONCLUSION Non-specialist mediated interventions for autism spectrum disorder demonstrate effectiveness across a range of outcomes for children with autism and their caregivers.
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Affiliation(s)
- Sadiq Naveed
- Kansas University Medical Center, Kansas City, Kansas, United States of America
| | - Ahmed Waqas
- Human Development Research Foundation, Rawalpindi, Pakistan
| | | | | | - Nisma Javed
- Services Institute of medical sciences, Lahore, Pakistan
| | - Muhammad Annas Tahir
- Kingsbrook Jewish Medical Center, New York City, New York, United States of America
| | - Sherief Ghozy
- Neurosurgery Department, El-Sheikh Zayed Specialized Hospital, Giza, Egypt
| | - Nusrat Jahan
- Rush University Medical Center, Chicago, IL, United States of America
| | - Anum Saeed Khan
- Westchester Medical Center-New York Medical College, Valhalla, NY, United States of America
| | - Atif Rahman
- University of Liverpool, Liverpool, England, United Kingdom
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42
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A Robot-Based Play-Drama Intervention May Improve the Joint Attention and Functional Play Behaviors of Chinese-Speaking Preschoolers with Autism Spectrum Disorder: A Pilot Study. J Autism Dev Disord 2019; 50:467-481. [DOI: 10.1007/s10803-019-04270-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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43
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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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44
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Corbett BA, Ioannou S, Key AP, Coke C, Muscatello R, Vandekar S, Muse I. Treatment Effects in Social Cognition and Behavior following a Theater-based Intervention for Youth with Autism. Dev Neuropsychol 2019; 44:481-494. [PMID: 31589087 DOI: 10.1080/87565641.2019.1676244] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This randomized clinical trial ( www.clinicaltrials.gov ID# NCT02276534) examined the impact of a peer-mediated, theater-based social skills intervention, SENSE Theater®, on social cognition and behavior in 77 youth (ages 8-16) with high-functioning autism spectrum disorder. Analysis of Covariance models revealed that post-treatment, the experimental group (n = 44) performed significantly better than the controls (n = 33) on NEPSY theory of mind (verbal) subtest, demonstrated increased neural evidence of memory for faces, and engaged in more cooperative play and verbal interaction with novel peers. The study extends previous findings showing that SENSE Theater® contributes to improvement in social cognition and behavior.
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Affiliation(s)
- Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center , Nashville , Tennessee , USA.,Vanderbilt Kennedy Center, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Sara Ioannou
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center , Nashville , Tennessee , USA.,Vanderbilt Kennedy Center, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Alexandra P Key
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center , Nashville , Tennessee , USA.,Department of Hearing and Speech Sciences, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Catherine Coke
- University School of Nashville, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Rachael Muscatello
- Vanderbilt Brain Institute, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Simon Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Ian Muse
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center , Nashville , Tennessee , USA
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45
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Quintin EM. Music-Evoked Reward and Emotion: Relative Strengths and Response to Intervention of People With ASD. Front Neural Circuits 2019; 13:49. [PMID: 31619969 PMCID: PMC6759939 DOI: 10.3389/fncir.2019.00049] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 07/16/2019] [Indexed: 12/26/2022] Open
Abstract
This review presents research findings showing that music is a unique domain to assess perception, reward, emotion, and associated physiological reactions and neural circuitry of people with autism spectrum disorder (ASD). There is growing evidence, reported in several studies in this review article, indicating that music is a relative strength of people with ASD including musical pitch perception, musical memory, and identification of music-evoked emotions. Listening to music activates neural circuits of reward and emotion response, which are described. Research presented shows adults with ASD also activate these systems when listening to music, although there may be developmental differences in the physiological and neural response to music in childhood and adolescence alongside typical behavioral response. Nonetheless, studies reviewed lend support to the use of music therapy and education for people with ASD, specifically to improve social skills and communication. Neural correlates of response to music therapy and education are also discussed. Taken together, findings reviewed provide evidence for music as a strength-based approach for ASD to assess reward and emotion response and as a powerful tool for intervention.
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Affiliation(s)
- Eve-Marie Quintin
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
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46
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The Unfulfilled Promise of the N170 as a Social Biomarker. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 5:342-353. [PMID: 31679960 DOI: 10.1016/j.bpsc.2019.08.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/05/2019] [Accepted: 08/31/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Greater affordability and accessibility of noninvasive brain imaging techniques have led to an increased interest in identifying biomarkers of various cognitive processes, particularly in the field of neurodevelopmental disabilities. Autism spectrum disorder (ASD) is one area of research in which strong claims in support of brain-based biomarkers, such as the face-sensitive N170 event-related potential response, are currently emerging. This study systematically examined the possibility of the N170 amplitude and latency measures serving as a biomarker of social information processing in ASD. METHODS The N170 response to faces and houses was recorded during passive picture viewing in 77 children with ASD, 7 to 16 years of age, at 2 time points (before and after a social skills intervention) 3 months apart. Social functioning was assessed using standardized behavioral tests, caregiver reports, and observational measures of naturalistic social interactions. RESULTS The results replicated prior findings of larger N170 amplitudes in response to faces than to houses, but the associations with the behavioral measures of social functioning were modest and not consistently present across the 2 assessment time points. Neither the amplitude nor the latency of the N170 response to faces was sensitive to the effects of a social skills intervention that produced behavioral improvements. CONCLUSIONS The N170 is a reliable event-related potential response reflecting the sensory-perceptual stage of face processing, but it does not fit the definition of a biomarker of social deficits in ASD because it is not sufficiently informative about heterogeneity of social functioning and is not sensitive to treatment effects.
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47
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Marro BM, Kang E, Hauschild KM, Normansell KM, Abu-Ramadan TM, Lerner MD. Social performance–based interventions promote gains in social knowledge in the absence of explicit training for youth with autism spectrum disorder. Bull Menninger Clin 2019; 83:301-325. [DOI: 10.1521/bumc.2019.83.3.301] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Youth with autism spectrum disorder (ASD) experience deficits in social knowledge. It has long been theorized that these youth must learn these skills explicitly, and social skills interventions (SSIs) have followed suit. Recently, performance-based SSIs have emerged, which promote in vivo opportunities for social engagement without explicit instruction. Effects of performance-based SSIs on social knowledge have not been examined. This study employs two discrete samples (one lab-based, one community-based) of youth with ASD to examine the effects of performance-based interventions on social knowledge. Results largely support the efficacy and effectiveness of improving social knowledge by performance-based interventions without explicit teaching. This indicates that youth with ASD may be able to learn these aspects of social cognition implicitly, rather than exclusively explicitly. The results of the current study also suggest that SSI content, dosage, and intensity may relate to these outcomes, which are important considerations in clinical practice and future studies.
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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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49
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Fida A, Naveed S, Waqas A. Non-Specialist Mediated Interventions for Autism Spectrum Disorder: An Overview. J Psychosoc Nurs Ment Health Serv 2019; 57:15-19. [PMID: 31042296 DOI: 10.3928/02793695-20190322-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social interactions and communication and repetitive stereotypical behaviors. Early recognition and treatment are critical to the treatment gains and prognosis of this disorder in children and adolescents. However, there can be several limitations to initiating a timely intervention, including financial constraints, limited resources, lack of trained providers, and lack of access to health care. In this context, non-specialist mediated interventions for ASD can provide an alternative approach to address the treatment gaps and lack of resources. The current article provides an overview of such interventions for children and adolescents with ASD. [Journal of Psychosocial Nursing and Mental Health Services, 57(5), 15-19.].
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50
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Kent C, Cordier R, Joosten A, Wilkes-Gillan S, Bundy A, Speyer R. A Systematic Review and Meta-analysis of Interventions to Improve Play Skills in Children with Autism Spectrum Disorder. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2019. [DOI: 10.1007/s40489-019-00181-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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