A Systematic Review of Play-Based Interventions Targeting the Social Communication Skills of Children with Autism Spectrum Disorder in Educational Contexts

The Seeking Proxies for Internal States (SPIS) Model of OCD - A Comprehensive Review of Current Findings and Implications for Future Directions

The Seeking Proxies for Internal States (SPIS) model of obsessive-compulsive disorder (OCD) explains symptoms of OCD as stemming from attenuated access to internal states, which is compensated for by using proxies, which are indices of these states that are more discernible or less ambiguous. Internal states in the SPIS model are subjective states that are not accessible to others, encompassing physiological states, motivations, preferences, memories, and emotions. Compensatory proxies in OCD include fixed rules and rituals as well as seeking and relying on external information. In the present review, we outline the SPIS model and describe its basic tenets. We then use the SPIS conceptualization to explain two pivotal OCD-related phenomena - obsessive doubt and compulsive rituals. Next, we provide a detailed overview of current empirical evidence supporting the SPIS in several domains, including physiological states, emotions, sense of understanding, decision-making, and sense of agency. We conclude by discussing possible neural correlates of the difficulty in accessing internal states, focusing on the anterior insular cortex (AIC) and highlighting potential clinical implications of the model to the treatment of OCD.

The importance and challenges of observing social interactions in autistic preschoolers during inclusive educational settings: A scoping review

Background and aims

A growing number of autistic children have access to inclusive education programs as early as kindergarten. However, little is known about how they actually participate in social interactions and develop their communicative skills according to the parameters of this environment. The aim of this article is to review observational studies on this topic and critically analyze their methodological choices by arguing on the aspects of communication skills noted in the observation grids. Disparities in the information collected depending on the method used have implications for understanding and supporting autistic children in an inclusive school environment.

Methods

Observational studies on social interactions of autistic preschoolers within inclusive preschool settings were scoped. The studies were analyzed according to the following parameters: aims of observation, method used for coding, communication partners considered (adults and peers), type of children's social engagement (initiatives and responses), diversity of communicative forms and communication functions, distinction and comparison of interactional contexts related to the activities, and whether changes linked to developmental variables are studied on an interindividual or longitudinal basis.

Results

Seventeen studies using the observation method in inclusive preschool settings were identified. Recordingmethods are mostly based on video recording. The coding grids mainly focus on autistic children while partners' behaviors (adults, peers) are often coded in less detail, thus providing littleinformation on their dynamic role in the interactions. Overall, autistic children were found to initiate interactions much less often than they respond to it. The data generally distinguish thecommunicative forms used by children and indicate a predominance of nonverbal means at preschool level. However, a few studies coded communicative functions, whether they areaddressed to children or produced by them. In addition, very few studies compare interactions across activity contexts. In addition, very few studies compare interactions across activity contexts.Results of some studies showed that children initiated interaction more frequently during free play than during work activity, but results are heterogeneous. Developmental trajectories in socialskills seem to be associated with the severity of autism and language skills, but longitudinal designs are still rare.

Conclusions and implications

Direct and fine-grained observation in the classroom is a key source of information about how communication takes place in preschool-inclusive settings. The data, despite some methodological challenges, offer opportunities for better adjustment based on professional objectives. Our review highlights the importance of offering occasions for initiatives to autistic children and training of neurotypical peers to better interact with autistic children and promote verbal communication. Further observational studies are needed to use more microanalytic measures of the functional quality of social interactions in autistic children, including joint comparisons between partners (adults vs. peers) and across contexts (e.g., play vs. structured development) so that appropriate strategies can be proposed in inclusive preschool settings.

The link between social communication and mental health from childhood to young adulthood: A systematic review

This systematic review investigates the current state of the literature on the association between social communication (SC) skills and mental health outcomes in children and young adults. We ran searches using terms describing SC and mental health in the following databases: PubMed, the Psychology and Behavioral Sciences Collection, APA PsychInfo, the Education Resource Information Center (ERIC) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). We included studies that both measured SC before age 21 years and assessed a mental health component, such as behavior/conduct problems, anxiety, depression, or emotional problems, before age 30. Only peer-reviewed articles published in or after 2000 were retained. In total, 27 studies were included in the narrative synthesis. Overall, the methodological quality was good. A longitudinal design was used in 12 studies, seven of which sourced data from the Avon Longitudinal Study of Parents and Children. Most studies investigated the broad concept of pragmatic language and its influence on internalizing, externalizing, and peer-relationship problems. The analyzed publications included population-based studies and studies investigating special populations with existing mental health problems or at increased risk of developing them. The population-based cross-sectional studies showed significantly higher rates of SC problems in children with mental health problems while those with a longitudinal design found earlier onset and more persistent mental health problems in children who had the most severe SC difficulties. Studies with special populations confirmed more SC problems as compared to typically developing children and worse mental health outcomes in children with additional SC difficulties. The available literature thus shows consistently significant, mostly moderate associations between SC skills and mental health outcomes. SC difficulties earlier in life can predict mental health problems and impact their trajectories.

SYSTEMATIC REVIEW REGISTRATION

[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=286598], identifier [CRD42022286598].