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Chen H, Ge S, Yao P, Yang T, Cao X, Sun D. Evaluation of the Quality of Management Guidelines for Children and Adolescents With Autism Spectrum Disorder. Psychol Rep 2024:332941241269510. [PMID: 39102695 DOI: 10.1177/00332941241269510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
OBJECTIVE To systematically assess the quality of management guidelines for children and adolescents with autism spectrum disorder, analyze key management recommendation differences and causes among guidelines, and provide better guideline assessments for clinical workers. METHODS Clinical guidelines for managing children and adolescents with autism were systematically retrieved from a database. Four reviewers independently evaluated the guidelines using the assessment guideline tool, Appraisal of Guidelines for Research and Evaluation II (AGREE II), and the intra-group correlation coefficient (ICC) was used to measure the consistency of the assessment guidelines among the four reviewers and the differences and reasons for the recommendations and supporting evidence were compared and analyzed. RESULTS A total of ten management guidelines for children and adolescents with autism spectrum disorder published from 2014 to 2022 were included in this study, with high overall agreement between raters (range of intra-group correlation coefficients: 53.3% ∼ 85.0%), and areas with better median scores and ranges in Protocol II were as follows: domain 1 (scope and purpose, median = 86.1%, 59.7%-98.6%), Domain 4 (clarity of statements, median = 88.2%, 38.9%-100.0%) and domain 6 (independence of editors, median = 71.9%, 0.0%-100.0%). Among the ten guidelines the guidelines published by the Scott Intercollegiate Guidelines Network in 2016 and by the National Institute for health and care excellence in 2021 scored high and were recommended for adoption, 88.7%, 84.9%, respectively. CONCLUSION There is considerable variation between the quality of guidelines for the management of children and adolescents with autism spectrum disorders.
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Affiliation(s)
- Huiling Chen
- The Key Laboratory of the 2nd Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Shiliang Ge
- Department of Burn Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Penghao Yao
- The Key Laboratory of the 2nd Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ting Yang
- Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xia Cao
- The Key Laboratory of the 2nd Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Dali Sun
- Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University, Kunming, China
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Sandbank M, Pustejovsky JE, Bottema-Beutel K, Caldwell N, Feldman JI, Crowley LaPoint S, Woynaroski T. Determining Associations Between Intervention Amount and Outcomes for Young Autistic Children: A Meta-Analysis. JAMA Pediatr 2024; 178:763-773. [PMID: 38913359 PMCID: PMC11197026 DOI: 10.1001/jamapediatrics.2024.1832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/20/2024] [Indexed: 06/25/2024]
Abstract
Importance Health professionals routinely recommend intensive interventions (ie, 20-40 hours per week) for autistic children. However, primary research backing this recommendation is sparse and plagued by methodological flaws. Objective To examine whether different metrics of intervention amount are associated with intervention effects on any developmental domain for young autistic children. Data Sources A large corpus of studies taken from a recent meta-analysis (with a search date of November 2021) of early interventions for autistic children. Study Selection Studies were eligible if they reported a quasi-experimental or randomized clinical trial testing the effects of a nonpharmacological intervention on any outcome in participant samples comprising more than 50% autistic children 8 years or younger. Data Extraction and Synthesis Data were independently extracted by multiple coders. Meta-regression models were constructed to determine whether each index of intervention amount was associated with effect sizes for each intervention type, while controlling for outcome domain, outcome proximity, age of participants, study design, and risk of detection bias. Data were analyzed from June 2023 to February 2024. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Main Outcomes and Measures The primary predictor of interest was intervention amount, quantified using 3 different metrics (daily intensity, duration, and cumulative intensity). The primary outcomes of interest were gains in any developmental domain, quantified by Hedges g effect sizes. Results A total of 144 studies including 9038 children (mean [SD] age, 49.3 [17.2] months; mean [SD] percent males, 82.6% [12.7%]) were included in this analysis. None of the meta-regression models evidenced a significant, positive association between any index of intervention amount and intervention effect size when considered within intervention type. Conclusions and Relevance Findings of this meta-analysis do not support the assertion that intervention effects increase with increasing amounts of intervention. Health professionals recommending interventions should be advised that there is little robust evidence supporting the provision of intensive intervention.
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Affiliation(s)
- Micheal Sandbank
- Department of Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill
| | | | | | - Nicolette Caldwell
- Department of Curriculum and Instruction, University of Arkansas, Fayetteville
| | - Jacob I. Feldman
- Department of Hearing and Speech Sciences, Frist Center for Autism and Innovation at Vanderbilt University, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Shannon Crowley LaPoint
- TEACCH Autism Program, Research Fellow, The University of North Carolina at Chapel Hill, Chapel Hill
| | - Tiffany Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Vanderbilt Brain Institute, Frist Center for Autism and Innovation at Vanderbilt University, Nashville, Tennessee
- Department of Communication Sciences and Disorders, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
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Beaurenaut M, Kovarski K, Destais C, Mennella R, Grèzes J. Spontaneous instrumental approach-avoidance learning in social contexts in autism. Mol Autism 2024; 15:33. [PMID: 39085896 PMCID: PMC11293119 DOI: 10.1186/s13229-024-00610-8] [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: 12/21/2023] [Accepted: 07/17/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Individuals with Autism Spectrum Condition (ASC) are characterized by atypicalities in social interactions, compared to Typically Developing individuals (TD). The social motivation theory posits that these difficulties stem from diminished anticipation, reception, and/or learning from social rewards. Although learning from socioemotional outcomes is core to the theory, studies to date have been sparse and inconsistent. This possibly arises from a combination of theoretical, methodological and sample-related issues. Here, we assessed participants' ability to develop a spontaneous preference for actions that lead to desirable socioemotional outcomes (approaching/avoiding of happy/angry individuals, respectively), in an ecologically valid social scenario. We expected that learning abilities would be impaired in ASC individuals, particularly in response to affiliative social feedback. METHOD We ran an online social reinforcement learning task, on two large online cohorts with (n = 274) and without (n = 290) ASC, matched for gender, age and education. Participants had to indicate where they would sit in a waiting room. Each seat was associated with different probabilities of approaching/avoiding emotional individuals. Importantly, the task was implicit, as participants were not instructed to learn, and emotional expressions were never mentioned. We applied both categorical analyses contrasting the ASC and TD groups and dimensional factor analysis on affective questionnaires. RESULTS Contrary to our hypothesis, participants showed spontaneous learning from socioemotional outcomes, regardless of their diagnostic group. Yet, when accounting for dimensional variations in autistic traits, as well as depression and anxiety, two main findings emerged among females who failed to develop explicit learning strategies: (1) autism severity in ASC correlated with reduced learning to approach happy individuals; (2) anxiety-depression severity across both ASC and TD participants correlated with reduced learning to approach/avoid happy/angry individuals, respectively. CONCLUSIONS Implicit spontaneous learning from socioemotional outcomes is not generally impaired in autism but may be specifically associated with autism severity in females with ASC, when they do not have an explicit strategy for adapting to their social environment. Clinical diagnosis and intervention ought to take into account individual differences in their full complexity, including the presence of co-morbid anxiety and depression, when dealing with social atypicalities in autism.
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Affiliation(s)
- Morgan Beaurenaut
- Laboratoire sur les Interactions Cognition, Action, Émotion (LICAÉ), Université Paris Nanterre, 200 avenue de La République, Nanterre Cedex, 92001, France.
| | - Klara Kovarski
- Sorbonne Université, INSPE, Paris, France
- Laboratoire de Psychologie du Développement et de l'Éducation de l'enfant (LaPsyDÉ), Université Paris Cité, CNRS, 46 rue Saint-Jacques, Paris, 75005, France
| | - Constance Destais
- Cognitive and Computational Neuroscience Laboratory (LNC2), Inserm U960, Department of Cognitive Studies, École Normale Supérieure, PSL University, 29 rue d'Ulm, Paris, 75005, France
| | - Rocco Mennella
- Laboratoire sur les Interactions Cognition, Action, Émotion (LICAÉ), Université Paris Nanterre, 200 avenue de La République, Nanterre Cedex, 92001, France
- Cognitive and Computational Neuroscience Laboratory (LNC2), Inserm U960, Department of Cognitive Studies, École Normale Supérieure, PSL University, 29 rue d'Ulm, Paris, 75005, France
| | - Julie Grèzes
- Cognitive and Computational Neuroscience Laboratory (LNC2), Inserm U960, Department of Cognitive Studies, École Normale Supérieure, PSL University, 29 rue d'Ulm, Paris, 75005, France.
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Minjarez MB, Gengoux GW, Paszek K, Liang JA, Ardel CM, Hardan AY, Frazier T. Adherence and Opportunity Frequency as Predictors of Communication Outcomes from Pivotal Response Parent Training. J Autism Dev Disord 2024:10.1007/s10803-024-06447-7. [PMID: 38976103 DOI: 10.1007/s10803-024-06447-7] [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: 06/19/2024] [Indexed: 07/09/2024]
Abstract
PURPOSE Access to intervention is a barrier for children with autism. As parent-mediated interventions have emerged to address this need, understanding implementation components contributing to child gains is critically important. Existing literature documents relationships between parent treatment adherence and child progress; however, less is understood about components, such as frequency of learning opportunities, which could also affect child outcomes. METHODS This study is a secondary analysis of data from a randomized controlled trial evaluating Pivotal Response Treatment group parent training (PRTG) compared to psychoeducation. Linear regression and mediational models were employed to identify potential predictors and mediators of outcome. RESULTS PRTG produced large increases in adherence and learning opportunities. In general, greater frequency of learning opportunities and adherence predicted better child outcomes. The best-fitting cross-sectional mediational models indicated at least partial mediational effects, whereby increased learning opportunities mediated the relationship between greater adherence and improved child outcomes. CONCLUSIONS This study provides preliminary evidence of how early gains in adherence may support parents to provide more frequent learning opportunities, which, in turn, yield positive effects on child social communication. Future large-scale research, with greater granularity of measurement, is needed to further understand the temporal relationships between these variables.
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Affiliation(s)
| | - Grace W Gengoux
- Stanford University School of Medicine, Stanford, United States.
- Department of Psychiatry & Behavioral Sciences, Division of Child & Adolescent Psychiatry, 401 Quarry Road, Stanford, CA, 94305-5719, USA.
| | | | | | | | | | - Thomas Frazier
- John Carroll University and SUNY Upstate Medical University, OH, United States
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Toby LM, Hustyi KM, Hartley BK, Dubuque ML, Outlaw EE, Logue JJ. Development and Preliminary Validation of the Patient Outcome Planning Calculator (POP-C): A Tool for Determining Treatment Dosage in Applied Behavior Analysis. Behav Anal Pract 2024; 17:601-614. [PMID: 38966276 PMCID: PMC11219665 DOI: 10.1007/s40617-023-00861-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 07/06/2024] Open
Abstract
Board certified behavior analysts (BCBA) are responsible for determining the medically necessary treatment dosage for patients (i.e., the number of hours of therapy a patient should receive per week to optimize progress) during applied behavior analysis (ABA) therapy. However, because there is currently no standard method for making these determinations, BCBAs must rely on their own clinical judgment. Given that clinical judgment may be underdeveloped in some BCBAs, particularly those who are newly certified, more formal strategies are needed to guide decision making as it relates to medical necessity and treatment dosage. In this article we describe the development of the Patient Outcome Planning Calculator (POP-C), a standardized decision-making tool designed to assist novice practitioners in determining the medically necessary ABA treatment intensity and appropriate treatment setting for individuals with autism spectrum disorder (ASD). We present preliminary reliability data as well as construct validity data indicating statistically significant correlations between the POP-C and several norm-referenced and criterion-referenced assessments commonly used to estimate skill level and the corresponding degree of support needed within the ASD population to inform the ABA treatment model and goals. Supplementary Information The online version contains supplementary material available at 10.1007/s40617-023-00861-6.
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Affiliation(s)
- Lauryn M. Toby
- LittleStar ABA Therapy, Congressional Blvd, Carmel, IN 46032 USA
| | | | | | - Molly L. Dubuque
- LittleStar ABA Therapy, Congressional Blvd, Carmel, IN 46032 USA
| | - Erica E. Outlaw
- LittleStar ABA Therapy, Congressional Blvd, Carmel, IN 46032 USA
| | - Jesse J. Logue
- LittleStar ABA Therapy, Congressional Blvd, Carmel, IN 46032 USA
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Peterson T, Dodson J, Sherwin R, Strale F. Comparative Analysis of Gender-Based Differences in Behavioral Mastery, Goals, and Characteristics in Autistic Individuals: An Applied Behavior Analysis Study. Cureus 2024; 16:e62427. [PMID: 39011183 PMCID: PMC11248749 DOI: 10.7759/cureus.62427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 06/14/2024] [Indexed: 07/17/2024] Open
Abstract
Introduction It is widely recognized that the prevalence and diagnosis of autism spectrum disorder (ASD) are more common in males than in females. Despite this, there is a significant gap in the body of autism research that investigates gender differences for treatment effects of applied behavior analysis (ABA) across a variety of measured variables. This research aims to comprehensively evaluate gender distinctions concerning target behavioral objectives, goals, and deficit variables. Materials and methods This study analyzed retrospective data from 100 participants, including 89 juveniles and four adults, with seven cases lacking age documentation, who underwent a three-month ABA program from March 19 to June 11, 2023. The ABA program included various methodologies such as functional analysis, discrete trial training, mass trials, and naturalistic training. Data on outcome measures, including target behavioral proficiency, age, average trials to proficiency, average teaching days to proficiency, open behavioral objectives, and target trends, were collected using the "Catalyst" software (Catalyst Software Corporation, New York, NY). Participant demographics were summarized using statistical analyses for categorical (gender and race/ethnicity) and continuous variables (percentage of mastered behavioral objectives, age, average trials, average teaching days, open objectives, percentage of failed objectives during maintenance, percentage of objectives with upward, downward, and flat trends). These statistics included mean, standard deviation, median, and range and were analyzed inferentially using nine separate two-sample independent t-tests and corresponding effect sizes using Cohen's d. Results There were no statistically significant disparities based on gender (p > 0.05) across all nine variables examined: Percentage of Targets Mastered, Age, Average Trials to Mastery, Average Teaching Days to Mastery, Open Targets, Percentage of Targets Failed in Maintenance, Percentage of Targets Trending Up, Percentage of Targets Trending Down, and Percentage of Targets Trending Flat, and wide confidence intervals were detected. Conclusions Non-significant gender differences in response to ABA treatments regarding these nine behavioral goals, mastery, and deficit variables may be relevant. They suggest that ABA treatments could be equally beneficial for both male and female autistic individuals. These results should be interpreted cautiously. The general pattern observed, characterized by broad confidence intervals, carries a degree of statistical uncertainty, which may suggest substantial gender differences. These results might question the prevailing beliefs about the variation in treatment response based on gender. This could profoundly impact clinical practices, implying that healthcare professionals should not favor one gender over another when suggesting ABA therapies. Instead, the treatment advice should be tailored to each child's unique requirements and traits, regardless of gender. The investigators expect these results to encourage additional research in this field. Comprehending the elements that affect treatment response is vital for improving treatment results and customizing care.
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Affiliation(s)
- Tami Peterson
- Hyperbaric Oxygen Therapy, The Oxford Center, Brighton, USA
| | - Jessica Dodson
- Applied Behavior Analysis, The Oxford Center, Brighton, USA
| | - Robert Sherwin
- Hyperbaric Oxygen Therapy, Wayne State University School of Medicine, Detroit, USA
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Asta L, Di Bella T, La Fauci Belponer F, Bruschetta M, Martines S, Basile E, Boncoddo M, Bellomo F, Cucinotta F, Ricciardello A, Turriziani L, Colombi C, Banchelli F, Cuoghi Costantini R, D’Amico R, Persico AM. Cognitive, behavioral and socio-communication skills as predictors of response to Early Start Denver Model: a prospective study in 32 young children with Autism Spectrum Disorder. Front Psychiatry 2024; 15:1358419. [PMID: 38873535 PMCID: PMC11170145 DOI: 10.3389/fpsyt.2024.1358419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/10/2024] [Indexed: 06/15/2024] Open
Abstract
Introduction The effectiveness of early interventions in young autistic children is well established, but there is great interindividual variability in treatment response. Predictors of response to naturalistic developmental behavioral interventions (NDBI), like the Early Start Denver Model (ESDM), are needed. Methods We conducted an exploratory study to prospectively seek predictors of response in 32 young children treated with ESDM after receiving an ASD diagnosis. All children were less than 39 months old (mean age: 29.7 mo), and received individualized ESDM for nine months. Tests were administered at the beginning, after 4 months, and at the end of treatment. Results Four children (12.5%) were "strong responders", 8 children (25.0%) were "moderate responders", and 20 children (62.5%) were "poor responders". A more favorable response to ESDM was significantly predicted by higher PEP-3 Expressive Language, Receptive Language, Cognitive Verbal/Preverbal, Visuo-Motor Imitation scores, higher GMDS-ER Personal/Social, and VABS-II Communication scores, by lower ADI-R C restricted/stereotypic behaviors, and by joint attention level. Discussion Most predictors showed a linear association with increasing response to ESDM, but GMDS-ER Personal-Social and joint attention level predicted strong response, while PEP-3 receptive language equally predicted moderate or strong response. Although larger samples will be necessary to reach definitive conclusions, in conjunction with prior reports our findings begin providing information able to assist clinicians in choosing the most appropriate treatment program for young autistic children.
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Affiliation(s)
- Lisa Asta
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Tiziana Di Bella
- Interdepartmental Program “Autism 0–90”, “G. Martino” University Hospital, Messina, Italy
| | | | - Marianna Bruschetta
- Interdepartmental Program “Autism 0–90”, “G. Martino” University Hospital, Messina, Italy
| | - Silvia Martines
- Interdepartmental Program “Autism 0–90”, “G. Martino” University Hospital, Messina, Italy
| | - Enrica Basile
- Interdepartmental Program “Autism 0–90”, “G. Martino” University Hospital, Messina, Italy
| | - Maria Boncoddo
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Fabiana Bellomo
- Interdepartmental Program “Autism 0–90”, “G. Martino” University Hospital, Messina, Italy
| | | | - Arianna Ricciardello
- Interdepartmental Program “Autism 0–90”, “G. Martino” University Hospital, Messina, Italy
| | - Laura Turriziani
- Center for Autism “Dopo di noi”, Barcellona Pozzo di Gotto, Messina, Italy
| | | | - Federico Banchelli
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Unit of Statistical and Methodological Support to Clinical Research, Modena University Hospital, Modena, Italy
| | - Riccardo Cuoghi Costantini
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Unit of Statistical and Methodological Support to Clinical Research, Modena University Hospital, Modena, Italy
| | - Roberto D’Amico
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Unit of Statistical and Methodological Support to Clinical Research, Modena University Hospital, Modena, Italy
| | - Antonio M. Persico
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Child and Adolescent Neuropsychiatry Program, Modena University Hospital, Modena, Italy
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Shrader SH, Mellen N, Cai J, Barnes GN, Song ZH. Cannabidiol is a behavioral modulator in BTBR mouse model of idiopathic autism. Front Neurosci 2024; 18:1359810. [PMID: 38784096 PMCID: PMC11112039 DOI: 10.3389/fnins.2024.1359810] [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: 12/22/2023] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction The prevalence of Autism Spectrum Disorder (ASD) has drastically risen over the last two decades and is currently estimated to affect 1 in 36 children in the U.S., according to the center for disease control (CDC). This heterogenous neurodevelopmental disorder is characterized by impaired social interactions, communication deficits, and repetitive behaviors plus restricted interest. Autistic individuals also commonly present with a myriad of comorbidities, such as attention deficit hyperactivity disorder, anxiety, and seizures. To date, a pharmacological intervention for the treatment of core autistic symptoms has not been identified. Cannabidiol (CBD), the major nonpsychoactive constituent of Cannabis sativa, is suggested to have multiple therapeutic applications, but its effect(s) on idiopathic autism is unknown. We hypothesized that CBD will effectively attenuate the autism-like behaviors and autism-associated comorbid behaviors in BTBR T+Itpr3tf/J (BTBR) mice, an established mouse model of idiopathic ASD. Methods Male BTBR mice were injected intraperitoneally with either vehicle, 20 mg/kg CBD or 50 mg/kg CBD daily for two weeks beginning at postnatal day 21 ± 3. On the final treatment day, a battery of behavioral assays were used to evaluate the effects of CBD on the BTBR mice, as compared to age-matched, vehicle-treated C57BL/6 J mice. Results High dose (50 mg/kg) CBD treatment attenuated the elevated repetitive self-grooming behavior and hyperlocomotion in BTBR mice. The social deficits exhibited by the control BTBR mice were rescued by the 20 mg/kg CBD treatment. Discussion Our data indicate that different doses for CBD are needed for treating specific ASD-like behaviors. Together, our results suggest that CBD may be an effective drug to ameliorate repetitive/restricted behaviors, social deficits, and autism-associated hyperactivity.
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Affiliation(s)
- Sarah H. Shrader
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY, United States
| | - Nicholas Mellen
- Departments of Neurology and Autism Center, Pediatric Research Institute, University of Louisville School of Medicine, Louisville, KY, United States
| | - Jun Cai
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY, United States
- Department of Pediatrics, Pediatric Research Institute, University of Louisville School of Medicine, Louisville, KY, United States
| | - Gregory N. Barnes
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY, United States
- Departments of Neurology and Autism Center, Pediatric Research Institute, University of Louisville School of Medicine, Louisville, KY, United States
- Department of Pediatrics, Pediatric Research Institute, University of Louisville School of Medicine, Louisville, KY, United States
| | - Zhao-Hui Song
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY, United States
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Grey I, Brennan D, Cody B. Outcomes for children with autism spectrum disorder and their families after two years of school based early intensive behavioural intervention. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024:17446295241231039. [PMID: 38346005 DOI: 10.1177/17446295241231039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
The effectiveness of a school based Early Intensive Behavioural Intervention (EIBI) program was assessed over a two-year period for a cohort of 16 pre-school children with autism spectrum disorder (ASD) and their families. Children with a mean age of 40 months, were assessed prior to intervention, after 1 year of intervention, and again after 2 years. Significant improvements were observed on measures of adaptive behaviour, communication ability and challenging behaviour. Parents of children attending the program also reported increased familial quality of life, specifically improved emotional and physical well-being and increased parenting capacity over the duration of the program. The current study suggests that EIBI for young children with ASD can be effective in facilitating improvements in communication ability, reducing challenging behaviours and improving quality of life for families. Children's pre-intervention adaptive skills appeared to be the strongest predictor of post intervention gains as initial level of adaptive ability was positively related to improved post-intervention outcomes.
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Affiliation(s)
- Ian Grey
- Department of Cognitive Science, College of Humanities and Social Sciences, United Arab Emirates University, United Arab Emirates
| | | | - Brettjet Cody
- Department of Cognitive Science, College of Humanities and Social Sciences, United Arab Emirates University, United Arab Emirates
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Peterson T, Dodson J, Strale F. Impact of Applied Behavior Analysis on Autistic Children Target Behaviors: A Replication Using Repeated Measures. Cureus 2024; 16:e53372. [PMID: 38435191 PMCID: PMC10907966 DOI: 10.7759/cureus.53372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/30/2024] [Indexed: 03/05/2024] Open
Abstract
INTRODUCTION Applied behavior analysis (ABA) is a primary evidence-based practice in treating autism spectrum disorder (ASD). Ongoing research is needed to report the results of ABA relative to attaining target behaviors. This study aims to replicate the results of previous research to determine the effectiveness of ABA of target behaviors in autistic children with a new timepoint sample of data. Materials & methods: A repeated measures analysis tracked 98 autistic children, which included four adult participants, over three timepoints during a one-month snapshot period from 6/7/23 to 7/7/23. This study used a retrospective chart review to gather data on target behaviors to determine the effectiveness of ABA treatments across age categories. A mixed (between x within) analysis of variance (ANOVA) and subsequent post hoc and interaction contrasts were used to determine statistical significance. RESULTS Mixed (between x within) ANOVA indicated statistical significance (sphericity assumed), F(2,160) = 32.893, and p < 0.05, across time. Using bootstrapped paired t-tests, multiple comparisons indicated p < 0.001 on all three multiple comparisons, with Bonferroni corrected α = 0.017. There was also a non-significant interaction effect (sphericity assumed) with (time) x (age category), F(8,160) = 0.333, p = 0.952, likely due to sizeable within-group variation resulting in a lowered statistical power. Conclusions: This replication found that autistic children receiving the ABA intervention demonstrated statistically significant improvement in target behaviors over the one-month snapshot period.
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Affiliation(s)
- Tami Peterson
- Hyperbaric Oxygen Therapy, The Oxford Center, Brighton, USA
| | - Jessica Dodson
- Applied Behavior Analysis, The Oxford Center, Brighton, USA
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Peterson T, Dodson J, Strale F. Predicting Behavioral Target Mastery With Age, Intensity and Duration, Open Targets, and Maintenance Failure With Applied Behavior Analysis in Individuals With Autism. Cureus 2024; 16:e53964. [PMID: 38469009 PMCID: PMC10925972 DOI: 10.7759/cureus.53964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/08/2024] [Indexed: 03/13/2024] Open
Abstract
Background Researchers have studied the effects of age, treatment intensity, and treatment duration with applied behavior analysis (ABA) outcomes in autistic individuals. This study's primary objective was to evaluate the predictive capabilities of age, intensity, and duration of treatment, open behavioral targets, and behavior maintenance failure on behavioral target mastery. Methods A retrospective cohort of 100 autistic individuals treated with ABA with functional analysis and discrete trial training, mass trials, and naturalistic training were treated and analyzed. Target behavioral mastery data was collected via a retrospective chart review contained within the "Catalyst" tracking software. ABA treatment was administered for three months between March 19, 2023, and June 11, 2023. Multiple linear regression was performed using the percentage of behavioral targets mastered as the dependent variable. The independent variables were age, average trials to behavioral mastery, average teaching days to behavioral mastery, and percentage of behavioral targets that failed in maintenance. Results The multiple linear regression model was statistically significant (R=0.443, R²=0.196, adjusted R2=0.150, F(5, 87)=4.239, p=0.002). The average teaching days to mastery (β=0.416, p=0.019) and percentage of targets failed in maintenance (β=0.201, p=0.047) significantly predicted the percentage of behavioral targets mastered. However, age (β=0.079, p=0.419), average trials to mastery (β=-0.271, p=0.114), and open targets (β=0.184, p=0.081) did not significantly predict the percentage of behavioral targets mastered. The analysis of variance (ANOVA) resulted in non-significant (p>0.05) age group differences between the above variables. Conclusions The predictor variables average teaching days to mastery (intensity and duration) and percentage of targets failed in maintenance had a statistically significant effect on the percentage of behavioral targets mastered. The predictor variables age, average trials to behavioral mastery (intensity and duration), and open behavioral targets had a non-significant influence on the percentage of behavioral targets mastered. A non-significant difference between age groups was found in all study variables.
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Affiliation(s)
| | - Jessica Dodson
- Applied Behavior Analysis, The Oxford Center, Brighton, USA
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12
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Fante C, De Luca Picione R, Dioni B, Manari T, Raffin C, Capelli F, Franceschini C, Lenzo V, Musetti A. Parental Quality of Life and Impact of Multidisciplinary Intervention for Children with Autism Spectrum Disorders: A Qualitative Study. J Autism Dev Disord 2024:10.1007/s10803-023-06225-x. [PMID: 38170430 DOI: 10.1007/s10803-023-06225-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
The presence of a child with Autism Spectrum Disorder (ASD) in the family can have a negative impact on parental Quality of Life (QoL), but evidence on how treatments for children with ASD can affect parental QoL is currently limited. In this qualitative study, we develop a semi-structured interview in order to investigate the impact of ASD on the QoL of mothers and fathers from a subjective perspective, as well as the effect of the intervention on their QoL and adjustment process. The sample consisted of 31 parents of children with ASD severity 2 or 3, aged 5 to 11 years, undergoing a multidisciplinary intervention. In order to identify emerging themes from the interview transcripts, a Thematic Analysis was conducted using a bottom-up approach. We identified three main themes relating to parental QoL (ASD impact on QoL, useful external resources, QoL improvement-related factors) and five themes relating to parents' views on the intervention (positive impact on parent, dissatisfaction with previous interventions, parental involvement, useful features, critical issues). The results provide indications of the process of parental adaptation and the components of interventions that foster an improvement in their QoL. In conclusion, living with a child with ASD can have a significant influence on a parents' QoL, not just physically and emotionally, but also in terms of general goals, family structure, and social interactions.
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Affiliation(s)
- Chiara Fante
- Institute for Educational Technologies, National Research Council, Via De Marini 6, Torre di Francia, Genoa, Italy.
| | | | - Barbara Dioni
- Fondazione Bambini e Autismo Onlus, Pordenone, Italy
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, Parma, Italy
| | - Tommaso Manari
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, Parma, Italy
| | - Cinzia Raffin
- Fondazione Bambini e Autismo Onlus, Pordenone, Italy
| | | | | | - Vittorio Lenzo
- Department Educational Sciences, University of Catania, Catania, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, Parma, Italy.
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13
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Zavaleta-Ramírez P, Rosetti M, Albores-Gallo L, López ON, González PP. Pediatric and psychiatric models of autism care in Mexico: Differences in diagnostic tools and prescribed interventions. Clin Child Psychol Psychiatry 2024; 29:232-244. [PMID: 37541309 DOI: 10.1177/13591045231193817] [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] [Indexed: 08/06/2023]
Abstract
Low- and middle-income countries face heterogeneity in the way clinicians' approach Autism Spectrum Disorder (ASD) diagnosis and treatment. The current study analyzes the diagnostic tools, laboratory tests, pharmacological and psychosocial interventions received by patients during the steps to diagnosis and treatment of two specialized care centers. Researchers interviewed families with a child with ASD receiving services at either a child psychiatric or a pediatric hospital. Of the total sample, 47% reported clinicians not using a diagnostic tool, 20% reported not receiving any psychosocial intervention, and 88% reported receiving a pharmacological prescription. Patients at the pediatric hospital were more likely to receive interventions with some components of Applied Behavioral Analysis, Early Start Denver Model, Treatment and Education of Autistic and Related Communication Handicapped Children, and Sensory integration therapy; while patients at the psychiatric hospital were more likely to undergo learning, daily living skills, and socialization therapies. Patients at the psychiatric hospital received significantly more requests to obtain auditory and vision tests whilst genetic testing and imaging were more common in the pediatric hospital. The range and variability in terms of diagnostic tools, laboratory tests, and treatment options observed for both sites reflect a lack of consensus. Recommendations to improve ASD diagnostic and treatment in Mexico are given.
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Affiliation(s)
- Patricia Zavaleta-Ramírez
- Hospital Psiquiátrico Infantil Dr. Juan N. Navarro, Servicios de Atención Psiquiátrica, Mexico City, Mexico
| | - Marcos Rosetti
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Instituto Nacional de Psiquiatría Dr. Ramón de la Fuente Muñiz, México City, México
| | - Lilia Albores-Gallo
- Hospital Psiquiátrico Infantil Dr. Juan N. Navarro, Servicios de Atención Psiquiátrica, Mexico City, Mexico
| | - Omar Nafate López
- Hospital de Especialidades Pediátricas, Tuxtla Gutiérrez, Chiapas, México
| | - Paula Padierna González
- Hospital Psiquiátrico Infantil Dr. Juan N. Navarro, Servicios de Atención Psiquiátrica, Mexico City, Mexico
- Fundación Alicia Koplowitz, Madrid, España
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14
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Alrehaili RA, ElKady RM, Alrehaili JA, Alreefi RM. Exploring Early Childhood Autism Spectrum Disorders: A Comprehensive Review of Diagnostic Approaches in Young Children. Cureus 2023; 15:e50111. [PMID: 38186518 PMCID: PMC10771115 DOI: 10.7759/cureus.50111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
Autism spectrum disorders (ASD) encompass a diverse range of developmental disabilities characterized by pervasive deficiencies in socialization, communication, and the manifestation of behavioral issues. This review aims to clarify the diagnostic criteria for ASD, explore available diagnostic tools, evaluate biomedical examinations facilitating ASD diagnosis, and discuss the approach to screening assessments for ASD. ASDs are prevalent conditions, with a globally estimated prevalence of 7.6 cases per 100 (one in 132), based on a comprehensive review of epidemiological studies. The precise cause of autism and other ASDs remains unknown; however, genetic and environmental factors likely contribute. Common signs and symptoms shared among individuals with autism include restricted repetitive behaviors and learning disabilities. Standardized methods, such as the Diagnostic and Statistical Manual, Fifth Edition (DSM-5), diagnostic instruments, a thorough medical history, multiple physical examinations, laboratory investigations, neuroimaging, and screening tests, play a pivotal role in early autism diagnosis and intervention. ASD is a lifelong neurodevelopmental condition characterized by multiple deficits. Early detection is anticipated to have a positive impact on outcomes.
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Affiliation(s)
- Ruba A Alrehaili
- Family Medicine, Academy of Family Medicine, Ministry of Health, Al-Madinah, SAU
| | - Reem M ElKady
- Radiology and Medical Imaging, Faculty of Medicine, Taibah University, Al-Madinah, SAU
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15
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Ralston AW, Brown K. Registered Behavior Technicians' Training Experiences for Severe Problem Behavior: A Survey. Behav Anal Pract 2023; 16:1175-1190. [PMID: 38076738 PMCID: PMC10700287 DOI: 10.1007/s40617-023-00809-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 06/01/2024] Open
Abstract
Registered Behavior Technicians (RBTs) are the primary paraprofessionals who deliver applied behavior analysis (ABA) services to individuals with autism spectrum disorder (ASD) under supervision of a Board Certified Behavior Analyst (BCBA). Effective training and supervision for RBTs providing ABA services is critical, especially for technicians working with children who exhibit severe behaviors. Recent research has assessed the needs of BCBAs working with individuals who exhibit severe problem behavior (Colombo et al., 2021). However, no research exists to identify the needs and ongoing training offered to the RBTs who provide ABA services to clients who exhibit severe problem behavior. Thus, the purpose of the current study was to survey RBTs for their initial training experiences and ongoing supports offered when working with clients who exhibit severe problem behavior. Results indicated that some RBTs reported appropriate initial and ongoing training, however, 13% reported receiving no initial training and 29% reported receiving no ongoing training when working with clients who engaged in severe problem behavior. In addition, 75% of RBTs reported sustaining an injury themselves and 36% reported their client sustained some type of injury. Suggestions for improvement for training RBTs working with this population and directions for future research are discussed.
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Affiliation(s)
| | - Kristopher Brown
- Progressive ABA Therapy Group- Boardman, Youngstoswn, OH 44512 USA
- Department of Psychology, Youngstown State University, Youngstown, OH 44555 USA
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16
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Kim J, Jung MW, Lee D. Reward learning improves social signal processing in autism model mice. Cell Rep 2023; 42:113228. [PMID: 37815916 DOI: 10.1016/j.celrep.2023.113228] [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: 02/21/2023] [Revised: 09/03/2023] [Accepted: 09/21/2023] [Indexed: 10/12/2023] Open
Abstract
Social and reward signal processing and their association are critical elements of social motivation. Despite the use of reward learning to improve the social interactions of patients with autism spectrum disorder (ASD), the underlying neural mechanisms are unknown. Here, we found different yet conjunct neuronal representations of social and reward signals in the mouse medial prefrontal cortex (mPFC). We also found that social signal processing is selectively disrupted, whereas reward signal processing is intact in the mPFC of Shank2-knockout mice, a mouse model of ASD. Furthermore, reward learning not only allows Shank2-knockout mice to associate social stimuli with reward availability, but it also rescues the impaired social signal processing. These findings provide insights into the neural basis for the therapeutic use of reward learning in ASD.
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Affiliation(s)
- Joowon Kim
- Center for Cognition and Sociality, Institute for Basic Science, Daejeon 34126, Korea; Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Korea
| | - Min Whan Jung
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Korea; Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Korea; Center for Synaptic Brain Dysfunction, Institute for Basic Science, Daejeon 34141, Korea.
| | - Doyun Lee
- Center for Cognition and Sociality, Institute for Basic Science, Daejeon 34126, Korea.
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17
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Li X, Li JC, Lu QQ, Zhang F, Zhang SQ. Research status and prospects of acupuncture for autism spectrum disorders. Front Psychiatry 2023; 14:942069. [PMID: 37304438 PMCID: PMC10248508 DOI: 10.3389/fpsyt.2023.942069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 02/24/2023] [Indexed: 06/13/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder and has a predilection for children. Its symptoms, such as lifelong social communication deficits and repetitive sensory-motor behaviors, put a huge burden on the patient's family and society. Currently, there is no cure for ASD, and some medications that can improve its symptoms are often accompanied by adverse effects. Among many complementary and alternative medicine (CAM) therapies, acupuncture has shown promising application potential, but after years of practice, it has not been recognized as the preferred CAM therapy for ASD. Therefore, we analyzed and discussed the clinical study reports of acupuncture in the treatment of ASD in the past 15 years from the aspects of study subjects, group setting, intervention modalities, acupoint selection, outcome evaluation, and safety. The data accumulated at present are not sufficient to support the clinical effectiveness of acupuncture in ASD and to justify its use in clinical practice. They provide, however, initial evidence of possible effectiveness and encourage further investigation in order to reach firm conclusions. Based on a comprehensive analysis, we believed that following the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) and Consolidated Standards of Reporting Trials (CONSORT), screening the optimal combination of acupoints applying a rigorous scientific study design, and performing the related functional experiments may be the effective way to convincingly test the hypothesis that acupuncture may be beneficial in ASD patients. The significance of this review is to provide a reference for researchers to carry out high-quality clinical trials of acupuncture in the treatment of ASD from the perspective of the combination of modern medicine and traditional Chinese medicine.
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Affiliation(s)
- Xiang Li
- Clinical Research Institute, Zhejiang Provincial People’s Hospital, Hangzhou Medical College, Hangzhou, China
| | - Ji-Cheng Li
- Clinical Research Institute, Zhejiang Provincial People’s Hospital, Hangzhou Medical College, Hangzhou, China
- Department of Anatomy, Shantou University Medical College, Shantou, China
- Medical Research Center, Yuebei People’s Hospital, Shantou University Medical College, Shaoguan, China
- Institute of Cell Biology, Zhejiang University School of Medicine, Hangzhou, China
| | - Qi-Qi Lu
- Medical Research Center, Yuebei People’s Hospital, Shantou University Medical College, Shaoguan, China
| | - Fan Zhang
- Medical Research Center, Yuebei People’s Hospital, Shantou University Medical College, Shaoguan, China
| | - Shan-Qiang Zhang
- Clinical Research Institute, Zhejiang Provincial People’s Hospital, Hangzhou Medical College, Hangzhou, China
- Department of Anatomy, Shantou University Medical College, Shantou, China
- Medical Research Center, Yuebei People’s Hospital, Shantou University Medical College, Shaoguan, China
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18
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Effects of repetitive transcranial magnetic stimulation combined with action-observation-execution on social interaction and communication in autism spectrum disorder: Feasibility study. Brain Res 2023; 1804:148258. [PMID: 36702183 DOI: 10.1016/j.brainres.2023.148258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 01/12/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To investigate the feasibility of a combined high-frequency rTMS (HF-rTMS) with action observation and execution (AOE) on social interaction and communication in children with Autistic Spectrum Disorder (ASD). MATERIALS AND METHODS Fifteen children underwent 10 sessions of 5-Hz HF-rTMS on the right inferior frontal gyrus combined with AOE. An experimental group received the real HF-rTMS while the control group received the sham one. For the AOE protocol, they were instructed to watch and imitate a video showing the procedure, including reaching and grasping tasks, gustatory tasks, and facial expressions. Their behavioural outcomes were evaluated using the Vineland Adaptive Behaviour Scale (VABS) and electroencephalograms (EEGs) recorded at three time points: baseline, immediately after each treatment, and at the 1-week follow-up after the 10th treatment. RESULTS There were increased VABS subitem scores in the experimental group, including the receptive, expressive, domestic, and community scores but no such increase was observed in the control group. For the EEG, the beta rhythm at C3 and C4 increased in the experimental group. Additionally, positive correlations were observed between changes in the scores for the expressive subitem and changes in the beta rhythm on the C4 electrode at baseline and immediately after treatment in the experimental group. The control group showed no significant differences in any items for both observation and imitation times. CONCLUSION Ten sessions of HF-rTMS combined with AOE could improve both the subitems of communication and daily living skills domain in children aged 7-12 years with ASD. Although it is still inconclusive, this behavioural improvement may be partly attributable to increased cortical activity, as evidenced by beta rhythms.
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Paquet A, Dionne C, Joly J, Rousseau M, Rivard M, Lemire C. Competency drivers to support implementation of early intensive behavioral intervention in large-scale community-based services: Perspectives of caseworkers and organization representatives. EVALUATION AND PROGRAM PLANNING 2023; 97:102211. [PMID: 36592543 DOI: 10.1016/j.evalprogplan.2022.102211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/23/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
Implementing evidence-based practices in "real-world" settings poses significant challenges. Organizations involved must address this issue by providing supportive infrastructures. Among the elements to consider are competency drivers, which refer to the selection, training, and supervision of caseworkers. The purpose of this study was to describe the perspectives of caseworkers and representatives on competency drivers that organizations put in place to support the implementation of early intensive behavioral intervention (EIBI) in large-scale community-based services. The sample consisted of 109 caseworkers and 23 organization representatives who completed questionnaires. Results demonstrated that respondents consider clinical support and training as key elements in EIBI implementation. However, despite recognizing these factors, respondents reported considerable variability in practices. It appears necessary to better define and plan the implementation of these competency drivers with a view to improving EIBI implementation.
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Affiliation(s)
- Annie Paquet
- Département de psychoéducation, Université du Québec à Trois-Rivières, 3351, boulevard des Forges, Trois-Rivières, Québec G8Z 4M3, Canada.
| | - Carmen Dionne
- Département de psychoéducation, Université du Québec à Trois-Rivières, 3351, boulevard des Forges, Trois-Rivières, Québec G8Z 4M3, Canada.
| | - Jacques Joly
- Département de psychoéducation, Université de Sherbrooke, 2500, boulevard de l'Université, Sherbrooke, Québec J1K 2R1, Canada.
| | - Myriam Rousseau
- CIUSSS Mauricie Centre-du-Québec, 3090, rue Foucher, Trois-Rivières, Québec G8Z 1M3, Canada.
| | - Mélina Rivard
- Département de psychologie, Université du Québec à Montréal, 100 rue Sherbrooke Ouest, Montréal, Québec H2X 3P2, Canada.
| | - Colombe Lemire
- Département de psychoéducation, Université du Québec à Trois-Rivières, 3351, boulevard des Forges, Trois-Rivières, Québec G8Z 4M3, Canada.
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Eckes T, Buhlmann U, Holling HD, Möllmann A. Comprehensive ABA-based interventions in the treatment of children with autism spectrum disorder - a meta-analysis. BMC Psychiatry 2023; 23:133. [PMID: 36864429 PMCID: PMC9983163 DOI: 10.1186/s12888-022-04412-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 11/22/2022] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Many studies display promising results for interventions that are based on Applied Behavior Analysis (ABA) in the treatment of autism spectrum disorder (ASD). METHODS This meta-analysis assessed the effects of such treatments on developmental outcomes in children with ASD and on parental stress based on 11 studies with 632 participants. RESULTS Compared to treatment as usual, minimal or no treatment, comprehensive ABA-based interventions showed medium effects for intellectual functioning (standardized mean difference SMD = 0.51, 95% CI [0.09; 0.92]) and adaptive behavior (SMD = 0.37, 95% CI [0.03; 0.70]). Language abilities, symptom severity or parental stress did not improve beyond the improvement in control groups. Moderator analyses indicate that language abilities at intake could influence the effect sizes and the influence of treatment intensity might decrease with older age. CONCLUSIONS Practical implications and limitations are discussed.
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Affiliation(s)
- Theresa Eckes
- Institute of Psychology, University of Münster, Fliednerstr. 21, 48149, Münster, Germany
| | - Ulrike Buhlmann
- Institute of Psychology, University of Münster, Fliednerstr. 21, 48149, Münster, Germany
| | - Heinz-Dieter Holling
- Institute of Psychology, University of Münster, Fliednerstr. 21, 48149, Münster, Germany
| | - Anne Möllmann
- Institute of Psychology, University of Münster, Fliednerstr. 21, 48149, Münster, Germany. .,Institute of Psychology, Clinical Psychology and Psychotherapy, University of Bremen, Grazer Str. 6, 28359, Bremen, Germany.
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21
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Changes in Autistic Symptoms and Adaptive Functioning of Children Receiving Early Behavioral Intervention in a Community Setting: A Latent Growth Curve Analysis. J Autism Dev Disord 2023; 53:901-917. [PMID: 34813033 DOI: 10.1007/s10803-021-05373-2] [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] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
Despite showing effects in well-controlled studies, the extent to which early intensive behavioral intervention (EBI) produces positive changes in community-based settings remains uncertain. Thus, our study examined changes in autistic symptoms and adaptive functioning in 233 children with autism receiving EBI in a community setting. The results revealed nonlinear changes in adaptive functioning characterized by significant improvements during the intervention and a small linear decrease in autistic symptoms from baseline to follow-up. The intensity of intervention, initial age, IQ and autistic symptoms were associated either with progress during the intervention or maintenance during the follow-up. The next step to extend this line of research involves collecting detailed data about intervention strategies and implementation fidelity to produce concrete recommendations for practitioners.
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Dixon MR, Yi Z, Sutton A, Pikula A. Randomized-controlled trial examining differing content of ABA therapy delivered to autistic children. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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23
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Cultural adaptation of ACT to support caregivers of autistic Latino children: A pilot study. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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Bottema-Beutel K. We must improve the low standards underlying "evidence-based practice". AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:269-274. [PMID: 36588301 DOI: 10.1177/13623613221146441] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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25
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Trembath D, Varcin K, Waddington H, Sulek R, Bent C, Ashburner J, Eapen V, Goodall E, Hudry K, Roberts J, Silove N, Whitehouse A. Non-pharmacological interventions for autistic children: An umbrella review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:275-295. [PMID: 36081343 DOI: 10.1177/13623613221119368] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT What is already known about the topic?The delivery of evidence-based interventions is an important part of the clinical pathway for many autistic children and their families. However, parents, practitioners, and policymakers face challenges making evidence informed decisions, due to the wide variety of interventions available and the large, and often inconsistent, body of evidence regarding their effectiveness.What this paper adds?This is a comprehensive umbrella review, also known as a 'review of reviews', which examined the range of interventions available, the evidence for their effectiveness, and whether effects were influenced by factors relating to individual children (e.g. chronological age, core autism characteristics, and related skills) or the ways interventions were delivered (by whom and in what setting, format, mode, and amount). There was evidence for positive therapeutic effects for some, but not all, interventions. No single intervention had a positive effect for all child and family outcomes of interest. The influence of child and delivery characteristics on effects was unclear.Implications for practice, research, and policyThe findings provide parents, practitioners, and policymakers with a synthesis of the research evidence to inform decision-making and highlight the importance of individualised approaches in the absence of clear and consistent evidence. The findings also highlight the need to improve consistency and completeness in reporting of research studies, so that the same questions may be answered more comprehensively in the future.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Andrew Whitehouse
- Telethon Kids Institute and The University of Western Australia, Australia
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Ouss L, Beauquier Maccotta B, Hervé MJ, Bompard C, Desvignes C, Velasquez P, Rusconi Serpa S, Quirot B. Interventions précoces chez les enfants avec autisme : place du vidéo feedback. Des interventions comportementales, à une approche centrée sur les interactions précoces et la sensibilité parentale. ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2023. [DOI: 10.1016/j.amp.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Effects of Integrative Autism Therapy on Multiple Physical, Sensory, Cognitive, and Social Integration Domains in Children and Adolescents with Autism Spectrum Disorder: A 4-Week Follow-Up Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121971. [PMID: 36553414 PMCID: PMC9776954 DOI: 10.3390/children9121971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
This study aimed to compare the effects of conventional autism therapy (CAT) and integrative autism therapy (IAT) in children and adolescents with autism spectrum disorder (ASD). A convenience sample of 24 children with ASD was recruited and underwent either CAT or IAT for 60 min/day, twice a week, for 20 sessions over 10 weeks. Outcome measures included the following: (1) physical domain (pediatric balance scale, PBS), (2) sensory domain (short sensory profile), (3) cognitive domains (functional independence measure, FIM; and childhood autism rating scale), and (4) social integration domain (Canadian occupational performance measure, COPM; short falls efficacy scale; and pediatrics quality of life questionnaire). Two-way repeated analysis of variance (ANOVA) was used to determine the intervention-related changes in the four domains across the pre-test, post-test, and follow-up test at p < 0.05. ANOVA showed significant interaction effects on the PBS, FIM, and COPM (p < 0.05) variables. Moreover, time main effects (p < 0.05) were observed in all four domain variables, but no group main effect was noted. This study provides promising evidence that IAT is more effective than CAT for managing children and adolescents with ASD.
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Dănciulescu T, Zaharia A. Piano with a Twist: A Pilot Study Exploring the Preliminary Effects of a Piano Therapy Program for Children with Autism Spectrum Disorder. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2022.101987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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MacNaul H, Wimberley J, Labay A, Neely L, Novotny M, Morgan B. Effects of an Adapted Telehealth Training Curriculum for Registered Behavior Technicians®. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2022; 7:1-12. [PMID: 36160310 PMCID: PMC9483257 DOI: 10.1007/s41252-022-00285-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
Objectives We evaluated a telehealth training curriculum to prepare Registered Behavior Technicians® (RBTs®) to conduct caregiver coaching on behavior analytic skills via telehealth. Methods A non-concurrent multiple baseline across therapists design was used to evaluate the training procedures delivered by Board Certified Behavior Analysts® (BCBAs®). All therapists (RBTs) worked with one family during the baseline and training phases and an additional session was conducted with a different family during the novelty probe condition to see if therapists were able to perform the newly acquired skills without BCBA support. Results Seven therapists who received behavioral skills training on the curriculum reached mastery criteria within three sessions. All RBTs were able to provide caregiver coaching via telehealth with high degrees of fidelity and were able to independently conduct a telehealth session with a new family without support from the BCBA. Conclusions Results of the current study provide support for the use of the telehealth training curriculum to prepare RBTs to conduct ABA services via telehealth.
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Affiliation(s)
- Hannah MacNaul
- Department of Educational Psychology, University of Texas at San Antonio, San Antonio, TX USA
| | | | | | - Leslie Neely
- Department of Educational Psychology, University of Texas at San Antonio, San Antonio, TX USA
| | - Marissa Novotny
- Department of Educational Psychology, University of Texas at San Antonio, San Antonio, TX USA
- Autism Treatment Center, San Antonio, TX USA
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Kingsdorf S, Pancocha K, Vadurova H, Dosedel T. Piloting an E-Learning Applied Behavior Analysis Course for Caregivers of Children with Autism in the Czech Republic. JOURNAL OF BEHAVIORAL EDUCATION 2022:1-32. [PMID: 36097521 PMCID: PMC9452282 DOI: 10.1007/s10864-022-09493-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
The telehealth model can allow for cost-effective supports in areas where limited applied behavior analysis (ABA) services are available. As a result, e-learning programs for parents of children with autism have become part of the telehealth paradigm. In the Czech Republic, one of the many places where there are limited ABA supports and no available ABA e-learning courses for families, the development of an e-learning course that is freely available, and linguistically and culturally appropriate, is needed. It was anticipated that this course could mirror some of the free e-learning materials available to English-speaking caregivers and provide foundational knowledge to later support more intensive ABA services. Therefore, a pilot study was developed to assess an ABA e-learning course for caregivers in the Czech Republic with the aim of validating its efficacy and assessing whether a synchronous component was needed for the best outcomes. The materials were not meant to replace best practices in more intensive caregiver training but provide foundational skills for later more successful local services. Results demonstrated that a total of 33 caregivers completed the course, making statistically significant gains in their ABA knowledge and rating the course highly. Interestingly, the addition of the synchronous component only impacted the knowledge gain outcome. Suggestions for supporting caregivers in e-learning course completion and directions for future research are additionally explored.
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Affiliation(s)
- Sheri Kingsdorf
- Institute for Research in Inclusive Education, Faculty of Education, Masaryk University, Poříčí 31a, 603 00 Brno, Czech Republic
| | - Karel Pancocha
- Institute for Research in Inclusive Education, Faculty of Education, Masaryk University, Poříčí 31a, 603 00 Brno, Czech Republic
| | - Helena Vadurova
- Institute for Research in Inclusive Education, Faculty of Education, Masaryk University, Poříčí 31a, 603 00 Brno, Czech Republic
| | - Tomas Dosedel
- Department of Sociology, Faculty of Social Studies, Masaryk University, Poříčí 31a, 603 00 Brno, Czech Republic
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The Efficacy of Early Interventions for Children with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11175100. [PMID: 36079029 PMCID: PMC9457367 DOI: 10.3390/jcm11175100] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/12/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022] Open
Abstract
The superiority of early interventions for children with autism spectrum disorders (ASDs) compared to treatment as usual (TAU) has recently been questioned. This study was aimed to investigate the efficacy of early interventions in improving the cognitive ability, language, and adaptive behavior of pre-school children with ASDs through a systematic review of randomized controlled trials (RCTs). In total, 33 RCTs were included in the meta-analysis using the random effects model. The total sample consisted of 2581 children (age range: 12–132 months). Early interventions led to positive outcomes for cognitive ability (g = 0.32; 95% CI: 0.05, 0.58; p = 0.02), daily living skills (g = 0.35; 95% CI: 0.08, 0.63; p = 0.01), and motor skills (g = 0.39; 95% CI: 0.16, 0.62; p = 0.001), while no positive outcomes were found for the remaining variables. However, when studies without the blinding of outcome assessment were excluded, positive outcomes of early interventions only remained for daily living skills (g = 0.28; 95% CI: 0.04, 0.52; p = 0.02) and motor skills (g = 0.40; 95% CI: 0.11, 0.69; p = 0.007). Although early intervention might not have positive impacts on children with ASDs for several outcomes compared to controls, these results should be interpreted with caution considering the great variability in participant and intervention characteristics.
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Kingsdorf S, Pančocha K, Troshanska J, Rasimi TR. Examining the perceptions of needs, services and abilities of Czech and North Macedonian caregivers of children with autism and trainers. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 70:479-492. [PMID: 38699490 PMCID: PMC11062262 DOI: 10.1080/20473869.2022.2111970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/04/2022] [Indexed: 05/05/2024]
Abstract
Effective practices for supporting families with autistic children ensure a match between their needs and the expectations and competencies of the clinician. Applied behavior analysis (ABA) services are a common provision for serving autistic individuals. However, in regions where ABA is in its infancy, like the Czech Republic and North Macedonia, culturally relevant resources, regulations for practice, and standardized coursework are missing. In their absence, it is necessary to investigate the degree to which practitioners in the regions are meeting the behavioral needs of families. Assessing this match can set the stage for establishing more stable and effective services in the areas, as well as neighboring countries with similar historical foundations. Therefore, a survey was conducted to examine the perceptions of caregivers and trainers (those who self-identified as providing support to families with autistic children). A total of 233 caregivers and 204 trainers participated. Analysis of the survey responses verified the lack of behavioral knowledge on the part of the trainers, the apparent lack of access to ABA services for families in both regions, a potential misalignment between family needs and training targets, and the disparities between the two countries. The information evaluated here can be used to guide preservice training, dissemination efforts, and regulations surrounding behavioral practices.
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Affiliation(s)
- Sheri Kingsdorf
- Institute for Research in Inclusive Education, Faculty of Education, Masaryk University, Brno, Czech Republic
| | - Karel Pančocha
- Institute for Research in Inclusive Education, Faculty of Education, Masaryk University, Brno, Czech Republic
| | - Jasmina Troshanska
- Department of Special Education and Rehabilitation, University of Tetovo, Tetovo, North Macedonia
| | - Teuta Ramadani Rasimi
- Department of Special Education and Rehabilitation, University of Tetovo, Tetovo, North Macedonia
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Brown KJ, Brodhead MT. Reported Effects of Noncompete Clauses on Practitioners in Applied Behavior Analysis. Behav Anal Pract 2022; 16:251-264. [PMID: 37006427 PMCID: PMC10050295 DOI: 10.1007/s40617-022-00718-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/26/2022] Open
Abstract
The purpose of the current study was to evaluate the reported impact of noncompete clauses (NCCs) on practitioners in the field of applied behavior analysis (ABA). Thirty-seven percent of respondents indicated they currently worked under a NCC, 33% reported working under one in the past, and 30% reported never working under one. Responses on the effects of NCCs on practitioners' personal and work lives were mixed. Some respondents reported benefits associated with working under an NCC such as increased pay and reduced commute. However, a concerning number of respondents reported being involved in litigation, having to partially or completely stop working in the field of ABA, having to turn away clients due to NCCs, or contemplating leaving the field altogether. Further, many owners reported using NCCs to protect trade secrets, to avoid losing clients, and reduce employee turnover. The impact of NCCs in ABA, the rights of employees and owners, and suggestions for potential solutions in the field are discussed.
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Affiliation(s)
- Kristopher J. Brown
- Department of Psychological Sciences and Counseling, Youngstown State University, One University Plaza, DeBartolo Hall Room 319, Youngstown, OH 44555 USA
| | - Matthew T. Brodhead
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, 620 Farm Lane, Erickson Hall Room 447, East Lansing, MI USA
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Choi KR, Lotfizadah AD, Bhakta B, Pompa-Craven P, Coleman KJ. Concordance between patient-centered and adaptive behavior outcome measures after applied behavior analysis for autism. BMC Pediatr 2022; 22:314. [PMID: 35624439 PMCID: PMC9137129 DOI: 10.1186/s12887-022-03383-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 05/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Applied behavior analysis (ABA) is an evidence-based approach to autism spectrum disorder that has been shown in clinical trials to improve child functional status. There is substantial focus in ABA on setting and tracking individualized goals that are patient-centered, but limited research on how to measure progress on such patient-centered outcomes. PURPOSE The purpose of this investigation was to assess concordance between patient-centered and standard outcome measures of treatment progress in a real-world clinical sample of children receiving ABA for autism spectrum disorder. METHODS This observational study used a clinical sample of children ages 3 to 16 years (N = 154) who received 24 months of ABA from an integrated health system. Concordance between three outcome measures after ABA was assessed using a correlation matrix: (1) patient-centered measures of progress on individualized treatment goals, (2) caregiver-centered measure of progress on treatment participation goals, and (3) the Vineland Adaptive Behavior Scales adaptive behavior composite. RESULTS There was limited concordance among measures at both 12 and 24 months of ABA. None of the patient-centered measures showed significant positive correlation with adaptive behavior composite difference scores at either 12 or 24 months, nor did the caregiver measure. The percentage of children achieving clinically meaningful gain on patient-centered goal measures increased between 12 and 24 months of ABA, while the percentage of children achieving clinically meaningful gains in adaptive behavior declined during the same time period. CONCLUSIONS In a health system implementation of ABA, there was limited concordance between patient-centered and standard measures of clinically meaningful treatment progress for children with ASD. Clinicians should have ongoing dialogue with patients and parents/caregivers to ensure that interventions for ASD are resulting in progress towards outcomes that are meaningful to patients and families.
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Affiliation(s)
- Kristen R Choi
- UCLA School of Nursing, 700 Tiverton Ave, Los Angeles, CA, 90049, USA.
- Department of Health Policy and Management, UCLA Fielding School of Public Health, 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA.
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, Pasadena, CA, 91101, USA.
| | - Amin D Lotfizadah
- Easterseals Southern California, 1063 McGaw Avenue, Suite 100, Irvine, CA, 92614, USA
| | - Bhumi Bhakta
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, Pasadena, CA, 91101, USA
| | - Paula Pompa-Craven
- Easterseals Southern California, 1063 McGaw Avenue, Suite 100, Irvine, CA, 92614, USA
| | - Karen J Coleman
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, Pasadena, CA, 91101, USA
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Gitimoghaddam M, Chichkine N, McArthur L, Sangha SS, Symington V. Applied Behavior Analysis in Children and Youth with Autism Spectrum Disorders: A Scoping Review. Perspect Behav Sci 2022; 45:521-557. [PMID: 36249174 PMCID: PMC9458805 DOI: 10.1007/s40614-022-00338-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 12/18/2022] Open
Abstract
AbstractThis manuscript provides a comprehensive overview of the impact of applied behavior analysis (ABA) on children and youth with autism spectrum disorders (ASD). Seven online databases and identified systematic reviews were searched for published, peer-reviewed, English-language studies examining the impact of ABA on health outcomes. Measured outcomes were classified into eight categories: cognitive, language, social/communication, problem behavior, adaptive behavior, emotional, autism symptoms, and quality of life (QoL) outcomes. Improvements were observed across seven of the eight outcome measures. There were no included studies that measured subject QoL. Moreover, of 770 included study records, only 32 (4%) assessed ABA impact, had a comparison to a control or other intervention, and did not rely on mastery of specific skills to mark improvement. Results reinforce the need for large-scale prospective studies that compare ABA with other non-ABA interventions and include measurements of subject QoL to provide policy makers with valuable information on the impacts of ABA and other existing and emerging interventions.
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Affiliation(s)
- Mojgan Gitimoghaddam
- University of British Columbia Faculty of Medicine, Vancouver, British Columbia Canada
| | | | - Laura McArthur
- Club Aviva Recreation Ltd., Coquitlam, British Columbia Canada
| | - Sarabjit S Sangha
- Club Aviva Recreation Ltd., Coquitlam, British Columbia Canada
- University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Australia
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Slade T, Duebel E, Ryan J. "Your double-blind RCT needs feminism": an argument for engaging critical theory in quantitative rehabilitation research. Disabil Rehabil 2022; 45:1563-1571. [PMID: 35507752 DOI: 10.1080/09638288.2022.2068679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Rehabilitation science has, for years, endorsed a connection between quantitative research and the philosophical assumptions of positivism. These assumptions can limit the scope of rehabilitation research, particularly in relation to matters of equity, diversity, and inclusivity. As our field moves toward a greater focus on inclusivity in research design and patient-centred care, it is imperative that we reconsider the theoretical foundations of rehabilitation research and practice. METHODS We provide an analysis of positivism on equity, diversity, and inclusivity within quantitative rehabilitation research, using the Participant Intervention Comparison Outcome (PICO) model to provide structure for the resultant discussion and recommendations. RESULTS Our analysis reveals that there are significant limitations and ethical concerns to engaging in positivism as the primary paradigm for quantitative rehabilitation research. We argue that decoupling of positivism and quantitative research methods may be warranted. CONCLUSIONS Equitable and inclusive rehabilitation research requires the researcher to consider variables which are neglected in the positivist paradigm. We argue that critical theory can equip researchers with a lens to better address injustices within rehabilitation research. We provide a series of recommendations for researchers to engage critical theory at each stage of the PICO model of clinical trials.IMPLICATIONS FOR REHABILITATIONCommon assumptions in quantitative rehabilitation research (i.e., positivism) can limit the utility of research findings to rehabilitation patients.Equitable, diverse, and inclusive participant samples in research better reflect the diversity of real world rehabilitation patients, helping us better serve these populations.Critical theory can help researchers and clinicians identify and avoid interventions that may cause harm to rehabilitation patients.Research and practice that prioritize concepts of "normalcy" (i.e., "normal gait," "normal behaviours") may perpetuate negative concepts of disability and further marginalize the individuals that our interventions aim to serve.
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Affiliation(s)
- Teri Slade
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Erin Duebel
- Department of Occupational Therapy, University of Alberta, Edmonton, Canada
| | - Jacalyn Ryan
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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Brown KJ. The Use of a Pictorially Enhanced Self-Instruction Packet to Improve Weekly Time Sheet Completion in an ABA Clinic. JOURNAL OF ORGANIZATIONAL BEHAVIOR MANAGEMENT 2022. [DOI: 10.1080/01608061.2022.2063221] [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]
Affiliation(s)
- Kristopher J. Brown
- Department of Psychological Sciences and Counseling, Youngstown State University, Youngstown, Ohio, USA
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Meza N, Rojas V, Escobar Liquitay CM, Pérez I, Aguilera Johnson F, Amarales Osorio C, Irarrázaval M, Madrid E, Franco JVA. Non-pharmacological interventions for autism spectrum disorder in children: an overview of systematic reviews. BMJ Evid Based Med 2022:bmjebm-2021-111811. [PMID: 35217568 DOI: 10.1136/bmjebm-2021-111811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/25/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the effectiveness of non-pharmacological interventions for the treatment of autism spectrum disorder (ASD) in children. DESIGN Overview of systematic reviews (SRs). PARTICIPANTS Children aged 12 years and under with ASD. SEARCH METHODS In October 2021, we searched Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO and Epistemonikos placing no restrictions on language or date of publication. INTERVENTIONS 17 non-pharmacological interventions compared with placebo, no-treatment (including waiting list) or other interventions (ie, usual care, as defined by the authors of each study). DATA COLLECTION AND ANALYSIS We rated the methodological quality of the included SRs using A Measurement Tool to Assess Systematic Reviews (AMSTAR 2). We reported the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) certainty of the evidence (CoE) according to the analysis conducted by the authors of the included SRs. MAIN OUTCOME MEASURES A multidisciplinary group of experts agreed on analysing nine critical outcomes evolving core and non-core ASD symptoms. PUBLIC AND PATIENT INVOLVEMENT STATEMENT Organisations of parents of children with ASD participated in external revision of the final version of the report. RESULTS We identified 52 reports that were within our scope, of which 48 were excluded for various reasons. After excluding less reliable SRs, we included four SRs. Non-pharmacological interventions (ie, Early Intensive Behavioural Intervention, Applied Behaviour Analysis, Picture Exchange Communication System and Naturalistic Developmental Behavioural Interventions) may have favourable effects on some core outcomes including language, social and functioning, play or daily living skills in children with ASD (with either no GRADE assessment, very low or low CoE). In addition, we identified a lack of report for other key outcomes in the included SRs (ie, restricted, repetitive behaviour; play and sensory processing). CONCLUSIONS Synthesised evidence regarding the efficacy of non-pharmacological interventions for children with ASD is scarce. High-quality SRs addressing the variety of both non-pharmacological interventions and relevant outcomes are needed. PROSPERO REGISTRATION NUMBER CRD42020206535.
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Affiliation(s)
- Nicolás Meza
- Interdisciplinary Centre for Health Studies (CIESAL), Cochrane Chile Associate Centre, Universidad de Valparaíso, Viña del Mar, Chile
| | - Valeria Rojas
- School of Medicine, Universidad de Valparaíso, Viña del Mar, Chile
- Autism program, Hospital Dr Gustavo Fricke, Viña del Mar, Chile
| | | | - Ignacio Pérez
- School of Medicine, Universidad de Valparaíso, Viña del Mar, Chile
| | | | - Claudia Amarales Osorio
- School of Medicine, Universidad de Valparaíso, Viña del Mar, Chile
- Pediatric Neurology Unit, Hospital Carlos van Buren, Valparaíso, Chile
| | - Matías Irarrázaval
- Department of Mental Health, Ministry of Health, Santiago, Chile
- Millenium Institute for Research in Depression and Personality, Santiago, Chile
| | - Eva Madrid
- Interdisciplinary Centre for Health Studies (CIESAL), Cochrane Chile Associate Centre, Universidad de Valparaíso, Viña del Mar, Chile
| | - Juan Victor Ariel Franco
- Associate Cochrane Centre - Research Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Virues-Ortega J, McKay NS, McCormack JC, Lopez N, Liu R, Kirk I. A callosal biomarker of behavioral intervention outcomes for autism spectrum disorder? A case-control feasibility study with diffusion tensor imaging. PLoS One 2022; 17:e0262563. [PMID: 35113904 PMCID: PMC8812884 DOI: 10.1371/journal.pone.0262563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/30/2021] [Indexed: 11/18/2022] Open
Abstract
Tentative results from feasibility analyses are critical for planning future randomized control trials (RCTs) in the emerging field of neural biomarkers of behavioral interventions. The current feasibility study used MRI-derived diffusion imaging data to investigate whether it would be possible to identify neural biomarkers of a behavioral intervention among people diagnosed with autism spectrum disorder (ASD). The corpus callosum has been linked to cognitive processing and callosal abnormalities have been previously found in people diagnosed with ASD. We used a case-control design to evaluate the association between the type of intervention people diagnosed with ASD had previously received and their current white matter integrity in the corpus callosum. Twenty-six children and adolescents with ASD, with and without a history of parent-managed behavioral intervention, underwent an MRI scan with a diffusion data acquisition sequence. We conducted tract-based spatial statistics and a region of interest analysis. The fractional anisotropy values (believed to indicate white matter integrity) in the posterior corpus callosum was significantly different across cases (exposed to parent-managed behavioral intervention) and controls (not exposed to parent-managed behavioral intervention). The effect was modulated by the intensity of the behavioral intervention according to a dose-response relationship. The current feasibility case-control study provides the basis for estimating the statistical power required for future RCTs in this field. In addition, the study demonstrated the effectiveness of purposely-developed motion control protocols and helped to identify regions of interest candidates. Potential clinical applications of diffusion tensor imaging in the evaluation of treatment outcomes in ASD are discussed.
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Affiliation(s)
- Javier Virues-Ortega
- School of Psychology, The University of Auckland, Auckland, New Zealand
- Facultad de Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Nicole S. McKay
- Department of Neurology, Washington University, St Louis, Missouri, United States of America
| | - Jessica C. McCormack
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Nerea Lopez
- Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Rosalie Liu
- School of Psychology, The University of Auckland, Auckland, New Zealand
| | - Ian Kirk
- School of Psychology, The University of Auckland, Auckland, New Zealand
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Dance intervention for negative symptoms in individuals with autism spectrum disorder: A systematic review and meta-analysis. Complement Ther Clin Pract 2022; 47:101565. [DOI: 10.1016/j.ctcp.2022.101565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 01/14/2022] [Accepted: 02/19/2022] [Indexed: 11/23/2022]
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Screening, Diagnosis and Early Intervention in Autism Spectrum Disorders. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020153. [PMID: 35204874 PMCID: PMC8870449 DOI: 10.3390/children9020153] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/04/2022] [Indexed: 02/05/2023]
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Mukhamedshina YO, Fayzullina RA, Nigmatullina IA, Rutland CS, Vasina VV. Health care providers' awareness on medical management of children with autism spectrum disorder: cross-sectional study in Russia. BMC MEDICAL EDUCATION 2022; 22:29. [PMID: 35012536 PMCID: PMC8751116 DOI: 10.1186/s12909-021-03095-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a complex developmental range of conditions that involves difficulties with social interaction and restricted/repetitive behaviors. Unfortunately, health care providers often experience difficulties in diagnosis and management of individuals with ASD, and may have no knowledge about possible ways to overcome barriers in ASD patient interactions in healthcare settings. At the same time, the provision of appropriate medical services can have positive effects on habilitative progress, functional outcome, life expectancy and quality of life for individuals with ASD. METHODS This online survey research study evaluated the awareness and experience of students/residents (n = 247) and physicians (n = 100) in the medical management of children with ASD. It also gathered the views and experiences of caregivers to children with ASD (n = 158), all based in Russia. RESULTS We have established that the Russian medical community has limited ASD knowledge among providers, and have suggested possible reasons for this. Based on results from online surveys completed by students/residents, non-psychiatric physicians, and caregivers of children diagnosed with ASD, the main problems pertaining to medical management of individuals with ASD were identified. Possible problem solving solutions within medical practice were proposed. CONCLUSIONS The results from this study should be considered when implementing measures to improve healthcare practices, and when developing models for effective medical management, due to start not only in Russia but also in a number of other countries.
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Affiliation(s)
- Y O Mukhamedshina
- Clinical Research Center for Precision and Regenerative Medicine, Kazan Federal University, Kremlevskaya St 18, Kazan, 420008, Tatarstan, Russia.
- Department of Histology, Cytology and Embryology, Kazan State Medical University, Kazan, Russia.
| | - R A Fayzullina
- Department of Propaedeutics of Pediatric Diseases and Faculty Pediatrics, Kazan State Medical University, Kazan, Russia
| | - I A Nigmatullina
- Department of Psychology and Pedagogy of Special Education, Kazan (Volga region) Federal University, Kazan, Russia
| | - C S Rutland
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
| | - V V Vasina
- Department of Psychology and Pedagogy of Special Education, Kazan (Volga region) Federal University, Kazan, Russia
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Spjut Janson B, Heimann M, Koch FS. Combining a Being Imitated Strategy With IBT Improves Basic Joint Attention Behaviors in Young Children With ASD. Front Psychiatry 2022; 12:784991. [PMID: 35069288 PMCID: PMC8777221 DOI: 10.3389/fpsyt.2021.784991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/10/2021] [Indexed: 11/17/2022] Open
Abstract
In the present study, we examined how an initial being imitated (BIm) strategy affected the development of initiating joint attention (IJA) among a group of children newly diagnosed with autism spectrum disorder (ASD). One group received 3 months of BIm followed by 12 months of intensive behavior treatment (IBT) which equaled treatment as usual whereas a second group received IBT for the entire 15-month study period. We utilized two measures of IJA: an eye gaze and a gesture score (point and show). IJA did not change during the first 3 months of treatment, nor were any significant between-group differences noted. However, at the end of the 15-month-long intervention period, the BIm group used eye gaze significantly more often to initiate joint attention. No significant change was noted for the gesture score. These results suggest that an early implementation of a being imitated strategy might be useful as less resource intensive but beneficial "start-up" intervention when combined with IBT treatment as a follow-up.
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Affiliation(s)
| | - Mikael Heimann
- Infant and Child Lab, Division of Psychology, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Felix-Sebastian Koch
- Infant and Child Lab, Division of Psychology, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
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Mathée-Scott J, Ellis Weismer S. Naturalistic parent-child reading frequency and language development in toddlers with and without autism. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2022; 7:23969415221136740. [PMID: 36438160 PMCID: PMC9685215 DOI: 10.1177/23969415221136740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND AIMS The efficacy of parent-child reading for supporting language development has been well-established in the neurotypical (NT) literature. For children with autism spectrum disorder, (ASD) who may be at risk for delays in language development, prior research has shown promise for shared book-reading interventions. Yet there has been limited research on naturalistic parent-child reading with autistic children to date. The present study aimed to fill this missing link in the current literature. METHODS Fifty-seven autistic toddlers participated at two developmental time points: Time 1 (Mage = 30.4 months) and Time 2 (Mage = 43.8 months). An NT control group (N = 31) was matched on age to a subset of the ASD group (N = 33). We assessed group differences in parent-child reading frequency between age-matched NT and autistic groups. Using a one-year follow-up design, we evaluated the relationship between parent-child reading and autistic children's language development. RESULTS Cross-group comparisons revealed that parents of age-matched NT children reported significantly more frequent weekly parent-child reading than parents of autistic toddlers. After a one-year follow-up with the autistic group, within-group analyses revealed that greater frequency of parent-child reading (controlling for maternal education, books in the home, and autism symptom severity) was associated with larger growth in autistic toddlers' receptive and expressive language skills. CONCLUSIONS AND IMPLICATIONS These findings have important clinical implications as they emphasize the potential of parent-child reading for supporting autistic children's language development. Findings demonstrate that frequency of parent-child reading is associated with language development over one year. Findings also demonstrate that parents of autistic children engage in less frequent parent-child reading than parents of age-matched NT peers, suggesting these parents may face more barriers to implementing parent-child reading than parents of NT children.
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Affiliation(s)
- Janine Mathée-Scott
- Janine Mathée-Scott, Waisman Center,
University of Wisconsin–Madison, Room 449, 1500 Highland Ave., Madison, WI
53705, USA.
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45
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Choi KR, Bhakta B, Knight EA, Becerra-Culqui TA, Gahre TL, Zima B, Coleman KJ. Patient Outcomes After Applied Behavior Analysis for Autism Spectrum Disorder. J Dev Behav Pediatr 2022; 43:9-16. [PMID: 34342287 PMCID: PMC8702444 DOI: 10.1097/dbp.0000000000000995] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 04/21/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The purpose of this study was to examine patterns of service receipt and patient outcomes for children receiving applied behavior analysis (ABA) for autism spectrum disorder (ASD) in an integrated health care system in which commercially insured children were covered by a state autism mandate. METHODS This retrospective, observational study used a random sample of children with ASD (3-17 yrs) who were members of a large integrated health care system in Southern California and referred for ABA between January 2016 and November 2018. From the 4145 children referred, a random stratified sample of 334 was selected to extract data from clinical reports over 24 months of services. The primary outcome measures were time in ABA and child adaptive behavior. RESULTS Thirteen percent of the sample never received ABA after referral. Of those who were referred for ABA, 66% initiated ABA and remained in services for 12 months, whereas less than half (46%) remained in services for 24 months. Having a history of special education was associated with longer time spent in ABA, whereas having a single parent was associated with discontinuation of ABA. A minority of children received a full ABA dose (28%), but the lowest functioning children still experienced clinically significant adaptive behavior gains after 24 months of ABA (p = 0.02). CONCLUSION In a health system implementation of ABA for children with ASD, there were high rates of ABA discontinuation and low ABA dosing. These challenges may diminish the potential benefits of ABA, even in a context in which there is mandated commercial insurance coverage.
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Affiliation(s)
- Kristen R. Choi
- School of Nursing, University of California, Los Angeles, Los Angeles, California
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Bhumi Bhakta
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | | | - Tracy A. Becerra-Culqui
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
- Southern California Permanente Medical Group, Kaiser Permanente, Pasadena, CA
| | - Teri L. Gahre
- Southern California Permanente Medical Group, Kaiser Permanente, Pasadena, CA
| | - Bonnie Zima
- Center for Health Services and Society, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Karen J. Coleman
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
- Southern California Permanente Medical Group, Kaiser Permanente, Pasadena, CA
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Sampaio F, Feldman I, Lavelle TA, Skokauskas N. The cost-effectiveness of treatments for attention deficit-hyperactivity disorder and autism spectrum disorder in children and adolescents: a systematic review. Eur Child Adolesc Psychiatry 2022; 31:1655-1670. [PMID: 33751229 PMCID: PMC9666301 DOI: 10.1007/s00787-021-01748-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 02/17/2021] [Indexed: 12/24/2022]
Abstract
Economic evaluations can help decision makers identify what services for children with neurodevelopmental disorders provide best value-for-money. The aim of this paper is to review the best available economic evidence to support decision making for attention deficit-hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in children and adolescents. We conducted a systematic review of economic evaluations of ADHD and ASD interventions including studies published 2010-2020, identified through Econlit, Medline, PsychINFO, and ERIC databases. Only full economic evaluations comparing two or more options, considering both costs and consequences were included. The quality of the studies was assessed using the Drummond checklist. We identified ten studies of moderate-to-good quality on the cost-effectiveness of treatments for ADHD and two studies of good quality of interventions for ASD. The majority of ADHD studies evaluated pharmacotherapy (n = 8), and two investigated the economic value of psychosocial/behavioral interventions. Both economic evaluations for ASD investigated early and communication interventions. Included studies support the cost-effectiveness of behavioral parenting interventions for younger children with ADHD. Among pharmacotherapies for ADHD, different combinations of stimulant/non-stimulant medications for children were cost-effective at willingness-to-pay thresholds reported in the original papers. Early intervention for children with suspected ASD was cost-effective, but communication-focused therapy for preschool children with ASD was not. Prioritizing more studies in this area would allow decision makers to promote cost-effective and clinically effective interventions for this target group.
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Affiliation(s)
- Filipa Sampaio
- Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, P.O Box 564, 751 22, Uppsala, Sweden.
| | - Inna Feldman
- grid.8993.b0000 0004 1936 9457Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, P.O Box 564, 751 22 Uppsala, Sweden ,grid.12650.300000 0001 1034 3451Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Tara A. Lavelle
- grid.67033.310000 0000 8934 4045Center for the Evaluation of Value and Risk, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA USA
| | - Norbert Skokauskas
- grid.5947.f0000 0001 1516 2393Regional Centre for Child and Youth Mental Health and Child Welfare, IPH, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway ,Child and Adolescent Mental Health Services, St. Olav Hospital, Trondheim, Norway
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Gasiewski K, Weiss MJ, Leaf JB, Labowitz J. Collaboration between Behavior Analysts and Occupational Therapists in Autism Service Provision: Bridging the Gap. Behav Anal Pract 2021; 14:1209-1222. [PMID: 34868823 PMCID: PMC8586098 DOI: 10.1007/s40617-021-00619-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 11/30/2022] Open
Abstract
Interdisciplinary collaboration is challenging, but necessary, to meet the needs of individuals with autism spectrum disorder. Among the dyadic interactions in interdisciplinary teams, the relationships between occupational therapy practitioners and board certified behavior analysts are uniquely challenging. The disciplines define evidence-based practice differently and approach intervention from different angles. Furthermore, there are fundamental differences in worldview between the disciplines. Both disciplines offer necessary treatment, and successful collaboration between these disciplines is essential for maximizing outcomes. Hence, finding ways to help bridge the gap between these professions, in particular, is essential. Common barriers to developing collaborative alliances include misperceptions of the other discipline, differences in terminology, and unprofessional behavior. This article reviews the history and foundational concepts of both disciplines, and the common approaches associated with each. In addition, models of collaboration are discussed, with suggestions for enhancing interdisciplinary communication and treatment. Successful collaborative treatment is predicated on an understanding of the value and expertise offered by different disciplines, and requires mutual respect and professional dialogue.
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Affiliation(s)
- Kristina Gasiewski
- Endicott College, Beverly, MA USA
- Melmark, 2600 Wayland Road, Berwyn, PA 19312 USA
| | - Mary Jane Weiss
- Endicott College, Beverly, MA USA
- Melmark, 2600 Wayland Road, Berwyn, PA 19312 USA
| | - Justin B. Leaf
- Endicott College, Beverly, MA USA
- Autism Partnership Foundation, Seal Beach, CA USA
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Acton R, Imberman S, Lovenheim M. Do Health Insurance Mandates Spillover to Education? Evidence from Michigan's Autism Insurance Mandate. JOURNAL OF HEALTH ECONOMICS 2021; 80:102489. [PMID: 34536824 DOI: 10.1016/j.jhealeco.2021.102489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 06/15/2021] [Accepted: 06/19/2021] [Indexed: 06/13/2023]
Abstract
Social programs and mandates are usually studied in isolation, but unintended spillovers to other areas can impact individual behavior and social welfare. We examine the presence of spillovers from health care policy to the education sector by studying how health insurance coverage affects the education of students with Autism Spectrum Disorder (ASD). We leverage a state mandate that increased insurance coverage of ASD-related services, which often are provided by both the private sector and within public schools. The mandate primarily affected coverage for children with private health insurance, so we proxy for private insurance coverage with students' economic disadvantage status and estimate effects via triple-differences. While we find little change in ASD identification, the mandate crowds-out special education supports for students with ASD. A lack of short-run impact on achievement supports our crowd-out interpretation and indicates that the mandate had little net effect on the academic achievement of ASD students.
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Nicolosi M, Dillenburger K. The University of California at Los Angeles‐Young Autism Project: A systematic review of replication studies. BEHAVIORAL INTERVENTIONS 2021. [DOI: 10.1002/bin.1830] [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)
- Michael Nicolosi
- Centre for Behaviour Analysis Queen's University Belfast Belfast UK
- Voce nel Silenzio Onlus Varese Italy
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Trembath D, Waddington H, Sulek R, Varcin K, Bent C, Ashburner J, Eapen V, Goodall E, Hudry K, Silove N, Whitehouse A. An evidence-based framework for determining the optimal amount of intervention for autistic children. THE LANCET CHILD & ADOLESCENT HEALTH 2021; 5:896-904. [PMID: 34672993 DOI: 10.1016/s2352-4642(21)00285-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/25/2021] [Accepted: 08/31/2021] [Indexed: 12/28/2022]
Abstract
The provision of timely, effective, and socially valid non-pharmacological intervention is at the core of efforts to support the development of young autistic children. These efforts are intended to support children to develop skills, empower their caregivers, and lay the foundation for optimal choice, independence, and quality of life into adulthood. But what is the optimal amount of intervention? In this Viewpoint, we review current guidelines and consider evidence from an umbrella review of non-pharmacological interventions for autistic children aged up to 12 years. We show the lack of consensus on the issue, identify factors that might be relevant to consider, and present an evidence-based framework for determining the optimal amount of intervention for each child, along with recommendations for future research.
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Affiliation(s)
- David Trembath
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Hannah Waddington
- Faculty of Education, Victoria University of Wellington, Wellington, New Zealand
| | - Rhylee Sulek
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Kandice Varcin
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Catherine Bent
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia
| | | | - Valsamma Eapen
- Academic Unit of Child Psychiatry South West Sydney Local Health District and Ingham Institute, University of New South Wales, Sydney, NSW, Australia
| | | | - Kristelle Hudry
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia
| | - Natalie Silove
- School of Medicine, University of Sydney, NSW, Australia
| | - Andrew Whitehouse
- Telethon Kids Institute, Northern Entrance, Perth Children's Hospital, Nedlands, WA, Australia.
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